Universität zu Köln

Kessler, Romain, Casan-Clara, Pere, Koehler, Dieter, Tognella, Silvia, Luis Viejo, Jose, Dal Negro, Roberto W., Diaz-Lobato, Salvador, Reissig, Karina, Rodriguez Gonzalez-Moro, Jose Miguel ORCID: 0000-0002-8446-3373, Devouassoux, Gilles, Chavaillon, Jean-Michel, Botrus, Pierre, Arnal, Jean-Michel, Ancochea, Julio, Bergeron-Lafaurie, Anne, De Abajo, Carlos, Randerath, Winfried J., Bastian, Andreas, Cornelissen, Christian G., Nilius, Georg, Texereau, Joelle B. and Bourbeau, Jean (2018). COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD. Eur. Resp. J., 51 (1). SHEFFIELD: EUROPEAN RESPIRATORY SOC JOURNALS LTD. ISSN 1399-3003

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Abstract

The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients. The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned all-cause hospitalisation days in the intention-to-treat (ITT) population. Secondary end-points included acute care hospitalisation days, BODE (body mass index, airflow obstruction, dyspnoea and exercise) index and exacerbations. Safety end-points included adverse events and deaths. For the 157 (disease management) and 162 (usual management) patients eligible for ITT analyses, all-cause hospitalisation days per year (mean +/- SD) were 17.4 +/- 35.4 and 22.6 +/- 41.8, respectively (mean difference -5.3, 95% CI -13.7 to -3.1; p=0.16). The disease management group had fewer per-protocol acute care hospitalisation days per year (p=0.047), a lower BODE index (p=0.01) and a lower mortality rate (1.9% versus 14.2%; p<0.001), with no difference in exacerbation frequency. Patient profiles and hospitalisation practices varied substantially across countries. The COMET disease management intervention did not significantly reduce unplanned all-cause hospitalisation days, but reduced acute care hospitalisation days and mortality in severe COPD patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kessler, Romain UNSPECIFIED UNSPECIFIED UNSPECIFIED Casan-Clara, Pere UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Tognella, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Luis Viejo, Jose UNSPECIFIED UNSPECIFIED UNSPECIFIED Dal Negro, Roberto W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Diaz-Lobato, Salvador UNSPECIFIED UNSPECIFIED UNSPECIFIED Reissig, Karina UNSPECIFIED UNSPECIFIED UNSPECIFIED Rodriguez Gonzalez-Moro, Jose Miguel UNSPECIFIED orcid.org/0000-0002-8446-3373 UNSPECIFIED Devouassoux, Gilles UNSPECIFIED UNSPECIFIED UNSPECIFIED Chavaillon, Jean-Michel UNSPECIFIED UNSPECIFIED UNSPECIFIED Botrus, Pierre UNSPECIFIED UNSPECIFIED UNSPECIFIED Arnal, Jean-Michel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ancochea, Julio UNSPECIFIED UNSPECIFIED UNSPECIFIED Bergeron-Lafaurie, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED De Abajo, Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bastian, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornelissen, Christian G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nilius, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Texereau, Joelle B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bourbeau, Jean UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-200371
DOI:	10.1183/13993003.01612-2017
Journal or Publication Title:	Eur. Resp. J.
Volume:	51
Number:	1
Date:	2018
Publisher:	EUROPEAN RESPIRATORY SOC JOURNALS LTD
Place of Publication:	SHEFFIELD
ISSN:	1399-3003
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE PULMONARY-DISEASE; COMPREHENSIVE SELF-MANAGEMENT; RANDOMIZED CONTROLLED-TRIAL; ACUTE EXACERBATION; HOSPITALIZATION; INTERVENTION; MORTALITY; THERAPY; BURDEN; IMPACT Multiple languages Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20037