HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 33/2/411    most recent 09031936.00005608v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vitacca, M. Articles by Scalvini, S. Search for Related Content PubMed PubMed Citation Articles by Vitacca, M. Articles by Scalvini, S.

Tele-assistance in chronic respiratory failure patients: a randomised clinical trial

¹ Divisione di Pneumologia, ⁵ Servizio di Telemedicina, Fondazione S. Maugeri, IRCCS, Lumezzane, ² Divisione di Pneumologia, Fondazione S. Maugeri, IRCCS, Montescano, ³ Divisione di Pneumologia, Fondazione S. Maugeri, IRCCS, Cassano delle Murge, and ⁴ Divisione di Pneumologia, Fondazione S. Maugeri, IRCCS, Veruno, Italy.

CORRESPONDENCE: M. Vitacca, Pneumology Division, Fondazione Salvatore Maugeri, Via Mazzini 129, 25066, Lumezzane, Italy. Fax: 39 308920262. E-mail: mvitacca{at}fsm.it

Keywords: Amyotrophic lateral sclerosis, chronic obstructive pulmonary disease, home care mechanical ventilation, telehealth telemedicine

Received: January 13, 2008
Accepted September 6, 2008

Chronic respiratory patients requiring oxygen or home mechanical ventilation experience frequent exacerbations and hospitalisations with related costs. Strict monitoring and care have been recommended. The aim of the present study was to primarily evaluate reduction in hospitalisations and, secondly, exacerbations, general practitioner (GP) calls and related cost-effectiveness of tele-assistance (TA) for these patients.

A total of 240 patients (101 with chronic obstructive pulmonary disease (COPD)) were randomised to two groups: an intervention group entered a 1-yr TA programme while controls received traditional care.

No anthropometric and clinical differences were found between groups both in baseline and in mortality (18% for TA, 23% for controls). Compared with controls, the TA group experienced significantly fewer hospitalisations (-36%), urgent GP calls (-65%) and acute exacerbations (-71%). Only COPD patients, as a separate group, had fewer hospitalisations, emergency room admissions, urgent GP calls or exacerbations. Each patient referred to staff a mean±SD 36±25 times. After deduction of TA costs, the average overall cost for each patient was 33% less than that for usual care.

In chronic respiratory failure patients on oxygen or home mechanical ventilation, a nurse-centred tele-assistance prevents hospitalisations while it is cost-effective. The chronic obstructive pulmonary disease group seems to have a greater advantage from tele-assistance.

This article has been cited by other articles:

				J. Escarrabill Discharge planning and home care for end-stage COPD patients Eur. Respir. J., August 1, 2009; 34(2): 507 - 512. [Abstract] [Full Text] [PDF]

				M Vitacca, M Mazzu, and S Scalvini Socio-technical and organizational challenges to wider e-Health implementation Chronic Respiratory Disease, May 1, 2009; 6(2): 91 - 97. [Abstract] [PDF]