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:
CreatorsEmailORCIDORCID Put Code
Kessler, RomainUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Casan-Clara, PereUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koehler, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tognella, SilviaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luis Viejo, JoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dal Negro, Roberto W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diaz-Lobato, SalvadorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reissig, KarinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rodriguez Gonzalez-Moro, Jose MiguelUNSPECIFIEDorcid.org/0000-0002-8446-3373UNSPECIFIED
Devouassoux, GillesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chavaillon, Jean-MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Botrus, PierreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnal, Jean-MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ancochea, JulioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bergeron-Lafaurie, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Abajo, CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Randerath, Winfried J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bastian, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornelissen, Christian G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nilius, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Texereau, Joelle B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bourbeau, JeanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
OBSTRUCTIVE PULMONARY-DISEASE; COMPREHENSIVE SELF-MANAGEMENT; RANDOMIZED CONTROLLED-TRIAL; ACUTE EXACERBATION; HOSPITALIZATION; INTERVENTION; MORTALITY; THERAPY; BURDEN; IMPACTMultiple languages
Respiratory SystemMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/20037

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