Remote Monitoring Shown to Reduce COPD Hospital Visits

(NIH.gov)

14 Mar. 2023. A study of people with COPD shows patients using a wearable electronic device to report health status have fewer unplanned hospital visits than before using the device. Results of the study assessing a system made by Spire Health in San Francisco appear in the 3 Mar. issue of the International Journal of COPD.

Chronic obstructive pulmonary disease or COPD is a progressive respiratory disorder causing damage to airways and air sacs, the elastic components of lungs that fill with air like small balloons. Cigarette smoking is the main cause of COPD, by a large proportion of people with the disease, about three in 10, never smoked. The two main types of COPD are emphysema, where air sac walls become damaged, or chronic bronchitis, where irritation or inflammation of the airways causes a build-up of mucus in the lungs making it difficult to breathe. National Heart, Lung, and Blood Institute says COPD affects some 15 million Americans, is a major cause of disability, and the fourth leading cause of death in the U.S.

Spire Health is a developer of devices called health tags that provide remote monitoring of a person’s heart and respiratory functions, including activity, and are cleared by FDA. The tags are small unobtrusive sensor patches that adhere to the wearer’s undergarments. While the devices contain electronic sensors, they can be laundered and last for a year. Data from health tags are transferred via Bluetooth to a home collection system, then sent via cellular signals to the person’s health care provider. A system with Spire Health algorithms at the health care provider alerts clinicians to changes in the wearer’s health status, which may not be detected by that person.

Hospitalization of participants for any reason

The study is a retrospective clinical trial of 126 people with COPD in the mid-Atlantic region of the U.S., with at least one unplanned emergency hospital visit in the previous 12 months, and who agreed to use health tags. The study team from Spire Health, Pulmonary Associates of Richmond, and University of Texas Health Science Center in San Antonio analyzed electronic health records of participants in the 12 months before starting use of health tags, and the next 12 months of wearing the tags.

Researchers looked primarily at hospitalization of participants for any reason in that period, as well as hospital visits for cardio-pulmonary reasons, length of hospital stays, emergency room visits, outpatient visits for breathing problems, use of corticosteroids for controlling inflammation, and continued adherence to using health tags. The study had no separate control or comparison group.

The authors report lower overall health care resource usage by participants after they began using health tags. The number of hospital visits for any reasons, the primary study endpoint, dropped by 65 percent for the group in the 12 months of using health tags, with about the same reduction in cardio-pulmonary hospital visits (64%), as well as fewer emergency room visits overall and for cardio-pulmonary reasons. However, out-patient visits increased, which the authors attribute to participants’ experiencing less serious health issues.

Michael Polsky, a pulmonologist at Pulmonary Associates of Richmond and the paper’s lead author calls the results “incredibly promising” and notes in a Spire Health statement, “Reducing acute health care utilization not only benefits patients but also leads to significant cost savings for health care providers and payers.”

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