COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD. Issue 1 (11th January 2018)

• Record Type: Journal Article
• Authors: Kessler, Romain; Casan-Clara, Pere; Koehler, Dieter; Tognella, Silvia; Viejo, Jose Luis; Dal Negro, Roberto W.; Díaz-Lobato, Salvador; Reissig, Karina; Rodríguez González-Moro, José Miguel; 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, Joëlle B.; Bourbeau, Jean
• Other Names: Bourbeau J. author non-byline.; Celli B. author non-byline.; Rocca J. author non-byline.; Wedzicha J. author non-byline.; Housset B. author non-byline.; Bucknall C. author non-byline.; Burgel P.R. author non-byline.; Vogelmeier C. author non-byline.; Canuet M. author non-byline.; Degot T. author non-byline.; Hirschi Santelmo S. author non-byline.; Schuller A. author non-byline.; Charpin D.A. author non-byline.; Lesavre N. author non-byline.; Palot A. author non-byline.; Chenivesse C. author non-byline.; Gonzalez J. author non-byline.; Similowski T. author non-byline.; Demory D. author non-byline.; Garnero A. author non-byline.; Goupil F. author non-byline.; Molinier O. author non-byline.; Paris A. author non-byline.; Jagot J.L. author non-byline.; Lafay M. author non-byline.; Salmeron S. author non-byline.; Laugros D. author non-byline.; Lerousseau L. author non-byline.; Lorillon G. author non-byline.; Schlemmer F. author non-byline.; Olaru I. author non-byline.; Paillot N. author non-byline.; Renolleau F. author non-byline.; Voicu E. author non-byline.; Pepin J.L. author non-byline.; Tamisier R. author non-byline.; Bornitz F. author non-byline.; Herth F. author non-byline.; Dreher M. author non-byline.; Krüger S. author non-byline.; Kweider S. author non-byline.; Müller T. author non-byline.; Fleimisch S. author non-byline.; Haidl P. author non-byline.; Heyse D.C. author non-byline.; Franke K.J. author non-byline.; Kropf C. author non-byline.; Lange D.U. author non-byline.; Westhoff M. author non-byline.; Priegnitz C. author non-byline.; Verlaan S. author non-byline.; Amaducci S. author non-byline.; Colato S. author non-byline.; Pietra A. author non-byline.; Villani M. author non-byline.; BErtacco S. author non-byline.; Trevisan F. author non-byline.; Bonadiman L. author non-byline.; Guarnaccia S. author non-byline.; Scavalli P. author non-byline.; Mattioli G.P. author non-byline.; Re A. author non-byline.; Tubaldi A. author non-byline.; Micallef E. author non-byline.; Rolo J. author non-byline.; Motta C. author non-byline.; Rampoldi C. author non-byline.; Aguar Benito C. author non-byline.; Brotons B. author non-byline.; Sanchez-Toril F. author non-byline.; Caballero F. author non-byline.; De Lucas P. author non-byline.; Morán L. author non-byline.; Gallego Dominguez R. author non-byline.; Riesco J.A. author non-byline.; Garcia Garcia A. author non-byline.; Iscar Urrutia M. author non-byline.; Gómez Punter R.M. author non-byline.; Vázquez Espinosa E. author non-byline.; Martinez M.L. author non-byline.; Pena Miguel T. author non-byline.; Mayoralas S. author non-byline.; Garcález, Ramólez J.L. author non-byline.;
• Is Part Of: European respiratory journal. Volume 51:Issue 1(2018)
• Publication Date: 2018-01-11
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01612-2017
• Languages: English
• ISSNs: 0903-1936

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. Lower all-cause mortality in multicomponent home-based disease management programme vs routine care in severe COPD http://ow.ly/sykh30gS5XO