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Active home surveillance system (COD19) in managing chronic obstructive pulmonary disease: lessons and future
Andrea Foppiani1,2, Valeria Calcaterra3,4, Chiara Montanari4,5
1International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.
Background:
During the COVID-19 pandemic, telemedicine became crucial for monitoring chronic conditions, including respiratory diseases.
Objectives:
This study, part of a larger cohort of COVID-positive patients, focuses on individuals with chronic obstructive pulmonary disease (COPD) monitored through an active home surveillance system (COD19).
Design:
Longitudinal telematic active surveillance study.
Methods:
The study included COVID-19-positive patients in home isolation, quarantined workers, and those discharged from ASST hospitals or emergency departments. At discharge, patients received a letter with isolation guidelines, a COD19 kit (oxygen meter, thermometer, protective devices), and instructions for monitoring clinical parameters. Regular phone check-ins by physicians were conducted, starting within 12 h of activation. A secure platform COD19 enabled data collection and communication between patients, healthcare providers, and regional authorities.
Results:
The study involved 1288 patients, including 226 (17.5%) with COPD, who were older (p < 0.001), had a higher BMI (p = 0.006), and were more frequently admitted from home isolation (p < 0.001). COPD patients also had higher mean body temperature (p = 0.011) and respiratory rate (p = 0.035), with a non-significant trend toward lower SpO2 values. Monitoring outcomes indicated that COPD patients were more likely to require higher levels of care (p < 0.001), and the only two deceased patients were from this group. The remote monitoring service received positive feedback, with a median answering ratio of 92%, reflecting strong patient participation and manageable monitoring processes.
Conclusion:
The findings underscore telemedicine's effectiveness in COPD management, ensuring continuity of care and smooth home-to-hospital transitions. The system enhanced accessibility, enabling consistent monitoring and timely interventions. As healthcare evolves, telemedicine remains a key tool in improving patient care and accessibility.
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