Domiciliary Cough Monitoring for the Prediction of COPD Exacerbations

Crooks, Michael G.; den Brinker, Albertus C.; Thackray-Nocera, Susannah; van Dinther, Ralph; Wright, Caroline E.; Morice, Alyn H.

Abstract

Introduction: Acute exacerbations of COPD (AE-COPD) are a leading cause of health service utilisation and are associated with morbidity and mortality. Identifying the prodrome of AE-COPD by monitoring symptoms and physiological parameters (telemonitoring) has proven disappointing and false alerts limit clinical utility. We report objective monitoring of cough counts around AE-COPD and the performance of a novel alert system identifying meaningful change in cough frequency. Methods: This prospective longitudinal study of cough monitoring included chronic obstructive pulmonary disease (COPD) patients experienced in telemonitoring that had two or more AE-COPD in the past year. Participants underwent cough monitoring and completed a daily questionnaire for 90 days. The automated system identified deteriorating trends in cough and this was compared with alerts generated by an established telemonitoring questionnaire. Results: 28 patients [median age 66 (range 46–86), mean FEV-1% predicted 36% (SD 18%)] completed the study and had a total of 58 exacerbations (43 moderate and 15 severe). Alerts based on cough monitoring were generated mean 3.4 days before 45% of AE-COPD with one false alert every 100 days. In contrast, questionnaire-based alerts occurred in the prodrome of 88% of AE-COPD with one false alert every 10 days. Conclusion: An alert system based on cough frequency alone predicted 45% AE-COPD; the low false alert rate with cough monitoring suggests it is a practical and clinically relevant tool. In contrast, the utility of questionnaire-based symptom monitoring is limited by frequent false alerts.

Citation

Crooks, M. G., den Brinker, A. C., Thackray-Nocera, S., van Dinther, R., Wright, C. E., & Morice, A. H. (2021). Domiciliary Cough Monitoring for the Prediction of COPD Exacerbations. Lung, 199(2), 131-137. https://doi.org/10.1007/s00408-021-00435-9

• Journal Article Type: Article
• Acceptance Date: Mar 4, 2021
• Online Publication Date: Apr 7, 2021
• Publication Date: 2021-04
• Deposit Date: May 10, 2022
• Publicly Available Date: May 12, 2022
• Journal: Lung
• Print ISSN: 0341-2040
• Electronic ISSN: 1432-1750
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 199
• Issue: 2
• Pages: 131-137
• DOI: https://doi.org/10.1007/s00408-021-00435-9
• Keywords: Chronic obstructive pulmonary disease; COPD; Exacerbation; Cough; Telehealth
• Public URL: https://hull-repository.worktribe.com/output/3752670