Elderly patients with COPD require more health care than elderly heart failure patients do in a hospital-based home care setting

Abstract

Background

Elderly patients with advanced stages of COPD or chronic heart failure (CHF) often require hospitalization due to exacerbations. We hypothesized that telemonitoring supported by hospital-based home care (HBHC) would detect exacerbations early, thus, reducing the number of hospitalization. We also speculated that patients with advanced COPD or CHF would present differences regarding exacerbation frequency and the need of HBHC.

Methods

The Health Diary system, based on digital pen technology, was employed. Patients aged ≥65 years with ≥2 hospitalizations the previous year were included. Exacerbations were categorized and treated as either COPD or CHF exacerbation by an experienced physician. All HBHC contacts (home visits or telephone consultations) were registered.

Results

Ninety-four patients with advanced diseases were enrolled (36 COPD and 58 CHF subjects) of which 53 subjects (19 COPD and 34 CHF subjects) completed the 1-year study period. Death was the major reason for not finalizing the study. Compared to the 1-year prior inclusion, the intervention significantly reduced hospitalization. Although COPD subjects were younger with less comorbidity, exacerbations and HBHC contacts were significantly greater in this group.

Conclusions

COPD subjects exhibit exacerbations more frequently, mainly due to disease characteristics, thus, demanding much more HBHC.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 16 July 2019

Publication date Collection: 2019

Volume: 14

Pages: 1569-1581

Affiliations

[1 ]Respiratory Medicine, Department of Medical and Health Sciences (IMH), Linköping University , Linköping, Sweden

[2 ]Research and Development Unit in Region Östergötland and Department of Medical and Health Sciences, Linköping University , Linköping, Sweden

[3 ]Department of Biomedical Engineering/Health Informatics, Linköping University , Linköping, Sweden

[4 ]Rise Research Institutes of Sweden Ab/Division Ict Sics East, Linköping University , Linköping, Sweden

Author notes

Correspondence: Hans Lennart PerssonDepartment of Medical and Health Sciences (IMH), Linköping University , SE-581 85, Linköping, SwedenTel [phone]Email lennart.persson@ 123456liu.se

Article

Publisher ID: 207621

DOI: 10.2147/COPD.S207621

PMC ID: 6642647

Copyright statement: © 2019 Persson et al.

License:

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Page count

Figures: 2, Tables: 6, References: 36, Pages: 13

Categories

Subject: Original Research