More information is needed to determine how physiological parameters vary prior to exacerbation to support routine domiciliary monitoring for predicting exacerbations in chronic obstructive pulmonary disease (COPD), according to a study published in the Journal of Clinical Medicine.
Ahmed M. Al Rajeh, MSc, and John R. Hurst, PhD, from UCL Respiratory, Royal Free Campus, University College London, conducted a systematic review of the effectiveness of monitoring physiological parameters to predict COPD exacerbations with a search of 5 electronic databases through April 6, 2016. They identified 16 studies that met the inclusion criteria.
“Even though most of the reviewed studies exhibited some significant positive results in the efficacy of physiological parameters in predicting/detecting COPD exacerbation, there are insufficient data to draw a secure conclusion in this review,” the researchers concluded. “This is due to the diversity of the designs, methods, and sample size of studies. The demand for technology to meet the needs of the COPD patient and society [is] increasing. Further clinical trials are needed to achieve that.”
Of the studies that were included in the analysis, 15 reported positive results in predicting COPD exacerbation by monitoring physiological parameters. In addition, 9 studies found a reduction in peripheral oxygen saturation prior to exacerbation onset. Three studies that examined peak flow and 2 studies that examined respiratory rate reported variation prior to or at exacerbation onset.
Using physiological parameters to predict COPD exacerbations appears to be promising, but further clinical trials should investigate the magnitude and time course of the physiological parameters before, during, and after the exacerbation episode, according to the researchers. In addition, they noted that telemonitoring could provide an interface for live communication to enable clinicians and patients to feel secure managing COPD and to detect anticipated exacerbations.
“Monitoring of physiological parameters may be useful in assisting earlier detection of COPD exacerbations but further, robust studies are required to confirm this. A particular challenge is how to set alarm limits for individual patients given the heterogeneity inherent in COPD and COPD exacerbations,” the study authors stated.
- Al Rajeh AM, Hurst JR. Monitoring of physiological parameters to predict exacerbations of chronic obstructive pulmonary disease (COPD): A systematic review. J Clin Med. 2016. doi:10.3390/jcm5120108