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Background  A home based tele-monitoring system was developed to assess the effects of heat stress (days > 25°C) on clinical and functional status in patients with chronic obstructive pulmonary disease (COPD).    Methods  Sixty-two COPD patients (GOLD II–IV) were randomized into a tele-monitoring Group (TG, N = 32) or Control Group (CG, N = 30). Tele-monitoring included 1) daily clinical status (COPD Assessment Test-CAT), 2) daily lung function and 3) weekly 6-minute walk test (6MWT). Duration of monitoring lasted a total of nine months (9 M).    Results  From June 1 st –August 31 st  2012, 32 days with heat stress (29.0 ± 2.5°C) were recorded and matched with 32 thermal comfort days (21.0 ± 2.9°C). During heat stress, the TG showed a significant reduction in lung function and exercise capacity (FEV 1 % predicted: 51.1 ± 7.2 vs. 57.7 ± 5.0%;  P  <0.001 and 6MWT performance: 452 ± 85 vs. 600 ± 76 steps;  P  <0.001) and increase in CAT scores (19.2 ± 7.9 vs. 16.2 ± 7.2;  P  <0.001).  Over summer, significantly fewer TG patients suffered exacerbation of COPD compared to CG patients (3 vs. 14;  P  = 0.006). Over entire 9 M follow-up, the TG group had fewer exacerbations compared to CG (7 vs. 22;  P  = 0.012), shorter cumulative hospital stay (34 vs. 97 days) and 43% fewer specialist consultations (24. vs. 42;  P  = 0.04).    Conclusion  Heat stress affects clinical and functional status in COPD. Tele-monitoring reduces exacerbation frequency and health care utilization during heat stress and other periods of the year.Trial registration  DRKS-ID:  DRK705 .

Tele-monitoring reduces exacerbation of COPD in the context of climate change–a randomized controlled trial