Article Dans Une Revue European Respiratory Journal Année : 2018

COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD

Romain Kessler
Pere Casan-Clara
  • Fonction : Auteur
Dieter Koehler
  • Fonction : Auteur
Silvia Tognella
  • Fonction : Auteur
Jose Luis Viejo
  • Fonction : Auteur
Roberto W. Dal Negro
  • Fonction : Auteur
Salvador Díaz-Lobato
  • Fonction : Auteur
Karina Reissig
  • Fonction : Auteur
Gilles Devouassoux
  • Fonction : Auteur
Jean-Michel Chavaillon
  • Fonction : Auteur
Pierre Botrus
  • Fonction : Auteur
Jean-Michel Arnal
  • Fonction : Auteur
Julio Ancochea
  • Fonction : Auteur
Anne Bergeron-Lafaurie
  • Fonction : Auteur
Carlos de Abajo
  • Fonction : Auteur
Winfried J. Randerath
  • Fonction : Auteur
Andreas Bastian
  • Fonction : Auteur
Christian G. Cornelissen
  • Fonction : Auteur
Georg Nilius
  • Fonction : Auteur
Joëlle B. Texereau
  • Fonction : Auteur
Jean Bourbeau
  • Fonction : Auteur

Résumé

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.

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Dates et versions

hal-05254223 , version 1 (15-09-2025)

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Citer

Romain Kessler, Pere Casan-Clara, Dieter Koehler, Silvia Tognella, Jose Luis Viejo, et al.. COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD. European Respiratory Journal, 2018, 51 (1), ⟨10.1183/13993003.01612-2017⟩. ⟨hal-05254223⟩
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