A Clinical Management Centre Value in Triage of COPD Telemonitoring Patients
Abstract
Telemonitoring is the systematic collection of clinical data from the patient’s home and its examination by a healthcare team. Chronic obstructive pulmonary disease COPD exacerbations contribute to disease progression and worse prognosis. Aim: to determine the benefits achieved by early detection of acute exacerbations of COPD (AECOPD) by telemonitoring, describing the experience of a specialised clinical management centre (CMC) which triaged the received alerts, confirmed the AECOPD, stratified them according to their level of severity and notified the doctors. Methods: 15 male COPD patients, all “C” and “D” GOLD groups were monitored of spO2, heart rate, blood pressure and skin temperature. For each patient, individual clinical alert thresholds were defined and calculated. Clinical alerts resulted in the CMC phoning the patient, completing a clinical questionnaire and confirming the presence of AECOPD and stratifying its severity. Only true positives were referred to a doctor. Results: During 18 months, 1,137 clinical alerts were detected but only 4.3% were true positives. Of these, 55.1% were level I, 36.7% level II and 8.2% level III. Conclusion: The study demonstrates the essential role of a clinical management centre in identifying, categorising and appropriately acting upon only real alerts to ensure that patients with AECOPD receive the right treatment as quickly and efficiently as possible.
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Copyright (c) 2017 Joana Belchior, Margarida Guedes, Diana António, Sandra Guedes, Maria Inmaculata Ramos, Syed Jafri, Pedro Costa, João Pereira
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