Assessing the Safety of Home Oximetry for Covid-19: A multi-site retrospective observational study
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Published version
Author(s)
Type
Journal Article
Abstract
Objectives
To determine the safety and effectiveness of home oximetry monitoring pathways safe for Covid-19 patients in the English NHS.
Design
Retrospective, multi-site, observational study of home oximetry monitoring for patients with suspected or proven Covid-19
Setting
This study analysed patient data from four Covid-19 home oximetry pilot sites in England across primary and secondary care settings.
Participants
A total of 1338 participants were enrolled in a home oximetry programme across four pilot sites. Participants were excluded if primary care data and oxygen saturations are rest at enrolment were not available. Data from 908 participants was included in the analysis.
Interventions
Home oximetry monitoring was provided to participants with a known or suspected diagnosis of Covid-19. Participants were enrolled following attendance to emergency departments, hospital admission or referral through primary care services.
Results
Of 908 patients enrolled into four different Covid-19 home oximetry programmes in England, 771 (84.9%) had oxygen saturations at rest of 95% or more, and 320 (35.2%) were under 65 years of age and without comorbidities. 52 (5.7%) presented to hospital and 28 (3.1%) died following enrolment, of which 14 (50%) had Covid-19 as a named cause of death. All-cause mortality was significantly higher in patients enrolled after admission to hospital (OR 8.70 [2.53-29.89]), compared to those enrolled in primary care. Patients enrolled after hospital discharge (OR 0.31 [0.15-0.68]) or emergency department presentation (OR 0.42 [0.20-0.89]) were significantly less likely to present to hospital than those enrolled in primary care.
Conclusions
This study find that home oximetry monitoring can be a safe pathway for Covid-19 patients; and indicates increases in risk to vulnerable groups and patients with oxygen saturations < 95% at enrolment, and in those enrolled on discharge from hospital. Findings from this evaluation have contributed to the national implementation of home oximetry across England.
To determine the safety and effectiveness of home oximetry monitoring pathways safe for Covid-19 patients in the English NHS.
Design
Retrospective, multi-site, observational study of home oximetry monitoring for patients with suspected or proven Covid-19
Setting
This study analysed patient data from four Covid-19 home oximetry pilot sites in England across primary and secondary care settings.
Participants
A total of 1338 participants were enrolled in a home oximetry programme across four pilot sites. Participants were excluded if primary care data and oxygen saturations are rest at enrolment were not available. Data from 908 participants was included in the analysis.
Interventions
Home oximetry monitoring was provided to participants with a known or suspected diagnosis of Covid-19. Participants were enrolled following attendance to emergency departments, hospital admission or referral through primary care services.
Results
Of 908 patients enrolled into four different Covid-19 home oximetry programmes in England, 771 (84.9%) had oxygen saturations at rest of 95% or more, and 320 (35.2%) were under 65 years of age and without comorbidities. 52 (5.7%) presented to hospital and 28 (3.1%) died following enrolment, of which 14 (50%) had Covid-19 as a named cause of death. All-cause mortality was significantly higher in patients enrolled after admission to hospital (OR 8.70 [2.53-29.89]), compared to those enrolled in primary care. Patients enrolled after hospital discharge (OR 0.31 [0.15-0.68]) or emergency department presentation (OR 0.42 [0.20-0.89]) were significantly less likely to present to hospital than those enrolled in primary care.
Conclusions
This study find that home oximetry monitoring can be a safe pathway for Covid-19 patients; and indicates increases in risk to vulnerable groups and patients with oxygen saturations < 95% at enrolment, and in those enrolled on discharge from hospital. Findings from this evaluation have contributed to the national implementation of home oximetry across England.
Date Issued
2021-09-14
Date Acceptance
2021-08-09
Citation
BMJ Open, 2021, 11, pp.1-9
ISSN
2044-6055
Publisher
BMJ Journals
Start Page
1
End Page
9
Journal / Book Title
BMJ Open
Volume
11
Copyright Statement
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor
National Institute for Health Research
Wellcome Trust
National Institute of Health Research
Identifier
https://bmjopen.bmj.com/content/11/9/e049235
Grant Number
n/a
UNS81609 - 215938/Z/19/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
COVID-19
telemedicine
primary care
public health
respiratory medicine (see thoracic medicine)
CARE
COVID-19
primary care
public health
respiratory medicine (see thoracic medicine)
telemedicine
COVID-19
Humans
Oximetry
Retrospective Studies
SARS-CoV-2
State Medicine
Humans
Oximetry
Retrospective Studies
State Medicine
COVID-19
SARS-CoV-2
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Date Publish Online
2021-09-04