The effects of real-time telemedicine consultations between hospital-based nurses and severe COPD patients discharged after exacerbation admissions

Hospitalisation with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes a major burden for the COPD patients and is a common cause for admissions and readmissions to medical wards. Objectives: To investigate the effect of one week of daily real-time telemedicine video consultations (teleconsultation) between hospital-based nurses specialised in respiratory diseases (telenurses) and patients with severe COPD discharged after AECOPD in addition to conventional treatment compared to the effect of conventional treatment. Methods: Patients admitted with AECOPD at two different locations were recruited at hospital discharge. They were randomly assigned (1:1) to either daily teleconsultation for one week in addition to conventional treatment, the TVC group or to conventional treatment, the CT group. The telemedicine equipment consisted of a briefcase with built-in computer including a web camera, microphone and measurement equipment. The primary outcome was the total number of readmissions within 26 weeks after discharge. Results: A total of 266 patients (mean age 71.5 years, SD 9.5 years) were allocated to either TVC (n=132) or CT (n=134). The unconditional mean number of readmissions after 26 weeks was 1.42 (SD 2.07) in the TVC group and 1.56 (SD 2.40) in the CT group. No significant difference was noted between the groups (p = 0.62). Secondary analysis revealed no significant difference between the two groups in mortality, readmission with AECOPD or readmission days after four, eight, twelve and twenty-six weeks.