Nurse tele-consultations with discharged COPD patients reduce early readmissions--an interventional study

Abstract

Introduction: Exacerbations of chronic obstructive pulmonary disease (ECOPD) are the most common cause for admissions and readmissions to medical wards worldwide.

Objectives: To investigate the effect on early readmissions of telemedicine video consultations (TVCs) between respiratory nurses placed at the hospital and COPD patients in their homes after a discharge from the hospital, which was caused by ECOPD.

Methods: This study was an interventional study in which all ECOPD were consecutively allocated into two groups (TVC or control) depending on their home municipality. The patient received daily TVC at home with a nurse based at the hospital for approximately one week. Thereafter, the patient received at least one follow-up call and they could call the nurse for the rest of the study period of 28 days. The telemedicine equipment was composed of a computer with a web camera, a microphone and measurement equipment.

Results: Within each of the two groups, TVC (n = 50) and control (n = 50), 12% and 22%, respectively, were readmitted [differences between rates -10% (95% confidence interval -25;5)] because of ECOPD. The multivariate Cox regression model showed the TVC assignment as a significant protective factor for early readmission [hazard ratio (HR) 0.25 (0.09-0.69)]. High age [HR 3.94 (1.46-10.6)] and male gender [HR 2.97 (0.99-8.97)] were associated with high hazard. Patient satisfaction was high.

Conclusions: In a hospitalised population with ECOPD, a nurse TVC assignment is protective against early readmission and reduces the days of readmission.