Abstract

Home-based care of individuals with Advanced Lung Disease (ALD), delivered with home-monitoring tools or broader Telemedicine (TM) interventions, has the potential to reduce the inequality of access to specialist centers, reduce the health care burden, improve patients’ quality of life, and prevent adverse outcomes associated with acute exacerbations through early identification. Current literature reports a high variability in the ways TM is provided and its efficacy, therefore there is an urgent need to perform new studies to test the most effective and re-source-sparing TM organizational and practical model. The “ideal” TM approach for patients with ALD would involve a comprehensive and integrated system that addresses the specific needs of these patients. The aim of the present research proposal is to analyze the effect of a telemonitoring pilot project on direct medical costs, health resource utilization, and mortality. We will carry out a monocentric, assessor-blind, two-arm (intervention/control) randomized controlled trial, enrolling 20 patients diagnosed with ALD evaluated for lung transplantation. In the inter-vention group, home telemonitoring will be based on few simple vital parameters, assessed au-tomatically and continuously by an Artificial Intelligent System, able to detect a worrisome trend and alert the clinical team. Primary outcomes will be health care utilization, mortality, and medication use. Secondary outcomes will be health-related QoL, psychological morbidity, lung function, and cost-effectiveness..

Keywords:Telemedicine; Lung disease; Digital medicine; COPD; Outcomes