Monitoring COPD Patients at Home by a Forced Oscillation Technique Device

The continuous progresses of medical science and technology and the improvement of life conditions have increased the life expectancy in industrialized countries: the result is the progressive population aging [UN, 2002]. One of the consequences of this trend is the increasing number of people suffering from chronic diseases.

Among these pathologies chronic obstructive pulmonary disease (COPD) is the more important for number of patients and deaths affecting 80 million people in the world [WHO, 2006]. The time course of the disease is characterized by stable periods broken up by intermittent acute exacerbations of the symptoms, during which a severe inflammatory process occurs, leading to increased airways obstruction. During exacerbations the risk of death is very high [Connors et al, 1996;Soler-Cataluna et al, 2005]. Moreover the frequency and severity of exacerbations correlate with the worsening of the health condition of the patient [Anzueto et al, 2009; Donaldson et al, 2002].

The burden of care of patients with COPD on the national health care systems and society is high. The utilization of health care resources by patients with COPD is primarily due to acute exacerbations requiring care in the emergency rooms and hospital [Dal Negro, 2008] .

In the last few years the need to rationalize the health care costs has prompted to the development of new technologies for the home monitoring of these patients mainly aimed at the early detection of the onset of exacerbations. This could help the development of new therapeutic and organizational models aimed at reducing the impact of such events on the quality of life of the patient and on the national health care systems.

Published data offer several different follow-up models of home monitoring of COPD. Written and electronic diaries, questionnaires, telephonic assistance by respiratory nurses or specialized clinical personnel and use of web-based call centers have all been suggested for the follow up of patients after discharge from hospitals. Even if positive results are reported in terms of reduction of in hospitalization [Vitacca et al, 2009] many COPD patients tend to underestimate the severity of their condition [Cote et al, 1998] and patient's compliance in recording their symptoms rapidly decreases with time [Cote et al, 1998]. Moreover, other authors address the difficulty to evaluate correctly the impact of such models on patient's quality of life and on the reduction of hospitalization and mortality rate [Ram et al, 2004; Bolton et al, 2010].