Using daily home oscillometry (OSC) can help patients prevent acute exacerbations of chronic obstructive pulmonary disease (AECOPD), according to study findings presented at the American Thoracic Society (ATS) 2023 International Conference, held in Washington, DC, May 19 to 24.
Advances in OSC allow at-home measurement of airway impedance (ie, obstruction and compliance). Researchers evaluated the relationship between abnormal impedance trends identified via home OSC and the onset of AECOPD symptoms.
The researchers conducted a 6-month double-blind home-monitoring study of 18 patients (>40 years of age; 11 women) with COPD (GOLD classification II-III, C-D). Unsupervised OSC measurements based on 30 to 60 seconds of tidal breathing were taken by patients (who did not see the measurements) using the portable PulmoScan device (Cognita Labs, US). These patients also answered COPD Assessment Test (CAT) questionnaires twice daily for more than 30 days. Standard of care for COPD management was continued by patients throughout the study period.
For the analysis, the researchers normalized OSC and CAT scores and computed 4-day running means (meant to reduce day-to-day variability). The researchers defined day zero of the study as the date that patients commenced AECOPD health care utilization (eg, prescription of oral corticosteroids/antibiotics, urgent-care/emergency-room visit, hospitalization). For each AECOPD that occurred during the study period, the researchers defined a 30-day window that began at day -20 (ie, 20 days prior to day zero) through day 10, looking at the 4-day mean OSC and CAT data for this period; baseline was defined as the mean from day -20 to day -15. Parameter optimization was accomplished with regression analysis of OSC data; maximized baseline difference prior to exacerbation was identified with dimension reduction. Dunnett’s post hoc test was used to compare baseline with the OSC regression parameter and CAT.
Daily oscillometry demonstrated significant change 5-7 days prior to AECOPD and may identify a window of opportunity for preventing exacerbations of COPD.
The final analysis included 15 moderate-to-severe AECOPD events that occurred during the study period. For these AECOPD events, the researchers found a significant change in the OSC regression parameter from baseline until 5 to 7 days prior to AECOPD (P <.05). Observed variability for OSC (objective physiological measurement) was lower than variability for CAT scores (subjective symptoms self-assessed by patient). High variability may explain the lack of statistically significant changes in CAT score from baseline prior to AECOPD day zero.
The researchers concluded that “Daily oscillometry demonstrated significant change 5-7 days prior to AECOPD and may identify a window of opportunity for preventing exacerbations of COPD.”
This article originally appeared on Pulmonology Advisor
Hickman N, Hughes AL, Biswas P, et al. Early detection of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) using at-home lung oscillometry. AJCCRM. 2023;207:A4499. doi:10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A4499