{
  "abstract": "Objectives Given increasing interest in admission avoidance, we evaluated the evidence to support virtual wards (VW) and hospital at home (HaH) models of care during exacerbations of chronic obstructive pulmonary disease (ECOPD).Design A systematic review and meta-analysis. A comprehensive search of MEDLINE (1946 to March 2024), Embase (1974 to March 2024) and CENTRAL (searched 22 March 2024) was conducted. Risk of bias and a random effects meta-analysis were performed.Population Adults with an ECOPD presenting to the hospital or who require hospital-led care.Interventions VW: defined as assessments and interventions delivered remotely or HaH (defined as assessments and interventions delivered by healthcare professionals in patient’s homes) care pathways, compared with hospital admission.Primary and secondary objectives Safety (mortality rate of all causes, in-patient, 7 days and 30 days) and readmission rate in 7 and 30 days. Length of stay in hospital and changes in pulmonary function tests.Results One study assessed VWs (reported in two publications) and 10 assessed HaH. There were no changes in survival or short-term readmission rates attributable to the interventions and no evidence that VW or HaH care pathways reduced the total time a patient spent under hospital-led care, whether at home or in the hospital.Conclusions More evidence is needed to support the widespread roll-out of HaH and especially VW pathways for ECOPD.PROSPERO registration number https://www.crd.york.ac.uk/PROSPERO/view/CRD42024517565.",
  "authors": [
    {
      "affiliations": [
        "Respiratory Care—College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Jubail, Saudi Arabia",
        "NIHR Midlands Patient Safety Research Collaboration, Department of Inflammation & Ageing, College of Medicine and Health, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK",
        "Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK"
      ],
      "name": "Bushra Alenazi"
    },
    {
      "affiliations": [
        "NIHR Midlands Patient Safety Research Collaboration, Department of Inflammation & Ageing, College of Medicine and Health, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK",
        "Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK"
      ],
      "name": "Christopher Hatton"
    },
    {
      "affiliations": [
        "NIHR Midlands Patient Safety Research Collaboration, Department of Inflammation & Ageing, College of Medicine and Health, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK",
        "Institute of Inflammation and Ageing, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK"
      ],
      "name": "Elizabeth Sapey"
    }
  ],
  "title": "What is the evidence for virtual wards or hospital-at-home care pathways for exacerbations of chronic obstructive pulmonary disease? A systematic review and meta-analysis",
  "uid": "fbc21c04-732b-5c29-aa60-937f7034d895"
}