SynthesisBMJ open respiratory research2026
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.
Synthesis in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
objectivesGiven 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).
designA 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.
interventionsVW: 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
objectivesSafety (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.
resultsOne 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.
conclusionsMore 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.
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