An international randomized study of a home-based self-management program for severe COPD: the COMET

Introduction: Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Design: Multicenter parallel randomized controlled, open-label superiority trial. Setting: Thirty-three hospitals in four European countries. Participants: A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. Intervention: The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center's routine practice. Main outcome measures: Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs.