A hybrid home-care program for COPD patients after an acute hospitalization: a real-life cohort study

<bold>Background:</bold> COPD is a major public health problem. In Israel, 3-month readmission and mortality rate after an acute exacerbation is 61% and 54% respectively. Digital health tools may improve outcomes in this population. We explored the feasibility of remote digital monitoring including home spirometry and measurement of patient-reported outcomes (PROMS) after hospital admission. <bold>Methods:</bold> Patients admitted with an acute COPD exacerbation were recruited prospectively. After discharge they were instructed in the use a home spirometer, activity wristband and pulse oximeter. The DATOS platform integrated wearables, home devices and PROMS data which were reviewed daily by a nurse case-manager. Spirometry and tele-consultation by a pulmonologist was done every 6 weeks for a period of 3 months. <bold>Results:</bold> From 8/2022 until 1/2024, 50 patients were recruited. Follow-up is ongoing. Median age was 66yrs (range 42-91), 46% were male, 59% were GOLD stage 3-4 and 48% had been previously seen by a pulmonologist. Mean CAT score was 15.8±9.8. Two patients died and 2 dropped out. 37 patients completed follow-up, 47 completed 2 virtual visits and 50 completed 1 virtual visit. There were 5 exacerbations (3 moderate, 2 mild) and no readmissions. Continuity of Care Score was fair. Digital tools were rated as user-friendly and well accepted. <bold>Conclusions:</bold> Remote monitoring of COPD patients after an acute exacerbation is feasible and safe. The use of home spirometry is a promising alternative to hospital-based testing. The number of exacerbations and readmissions was lower than expected from the literature. Patient satisfaction scores are fair. Digital health tools are well tolerated in this patient population.