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

What is it about?

We report the results of COMET, the COPD Patient Management European Trial, which investigated a comprehensive disease management program for severe COPD that included a self-management program; home telemonitoring; care coordination; and timely medical care when needed. We enrolled patients with severe COPD, and compared patients managed for 1 year with the new program to patients managed for 1 year with the usual routine COPD management program used at each study hospital or clinic. The main measure we used to guage the success of the program and to compare the two groups of patients was the number of unplanned hospitalisation days experienced by each group during 1 year of follow-up. Hospitalisation days were carefully monitored and evaluated by an independent committee to verify the cause and length of each hospital stay. At the conclusion of the study, the average number of hospitalisation days/year per patient was lower for patients in the new program than for patients in routine program (17.4 ± 35.4 vs 22.6 ± 41.8), but the difference was not statistically significant (p=0.16). This primary result prevented us from definitively concluding that the new program was better than the routine program. However, patients managed with the new program had a significantly better COPD severity index and many fewer of them died (1.9% vs 14.2%). Taken together, these results suggest that the COMET disease management program could have benefits for patients with severe COPD and that it warrants further study.

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