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<p>This multicentre, non-randomized, quasi-experimental study evaluated the effectiveness of the ADLIFE digital toolbox—comprising clinical decision support, care-plan management, and patient empowerment—for patients aged &gt;55 with chronic obstructive pulmonary disease and chronic heart failure. Across four pilot sites (Spain, UK, Denmark, and Israel), 185 patients received the intervention and were compared with 185 retrospective standard-of-care control matched using propensity score. The primary outcome was the number of emergency room (ER) visits, analyzed through multivariate hurdle regression. Results in the pooled analysis (<i>N</i> = 370) indicated that while ADLIFE was associated with a significant reduction in the likelihood of an initial ER visit (OR 0.55; 95% CI: 0.31–0.96), no significant differences were found for subsequent visits among patients who had already utilized emergency services (IRR 1.74; 95% CI: 0.88–3.43). Significant effect heterogeneity was observed, with a reduction achieved in only one location (AMCA: OR 0.30; 95% CI: 0.15–0.63). These findings suggest that while digitally enabled care models hold potential for initial acute care prevention, their effectiveness is heavily contingent upon complex contextual factors. Given the small sample size and site-specific results, these data should be interpreted with caution. Trial registration: ClinicalTrials.gov; NCT05575336; September 2022.</p>

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Assessment of the ADLIFE intervention as a digital solution for patients with advanced chronic diseases: a quasi-experimental trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月21日

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  • Borja García-Lorenzo,
  • Ania Gorostiza,
  • Nerea González,
  • Igor Larrañaga,
  • Ángel Moro,
  • Ana Ortega-Gil,
  • Beñat Zubelzu,
  • Remedios Vega,
  • Laura de La Higuera,
  • Rachelle Kaye,
  • Gil Levy,
  • Olga Vishnevetsky,
  • Anne Dichmann Sorknæs,
  • Rikke Lyngholm Christensen,
  • Natassia Kamilla Juul,
  • Harpal Randeva,
  • Tim Robbins,
  • Michelle Yorkston,
  • Gokce B. Laleci Erturkmen,
  • Mustafa Yuksel,
  • Bunyamin Sarigul,
  • Theodoros N. Arvanitis,
  • Omid Pournik,
  • Chao Tong,
  • José I. Aznar-Baranda,
  • Jessica Caballero-García,
  • Gontzal Vallejo-Setién,
  • Mikael Lilja,
  • Marie Holm Sherman,
  • Anne Swoboda,
  • Oliver Groene,
  • Janika Bloemeke-Cammin,
  • Dipak Kalra,
  • Roma Maguire,
  • Lisa McCann,
  • Morven Miller,
  • Nicolás Francisco González López,
  • Leire Ortiz de Elguea,
  • Miguel Ángel Ogueta Lana,
  • Itxaso Alayo,
  • Urko Aguirre,
  • Barbara López Perea,
  • Michal Yeshayahu,
  • Elinor Dahary Halevy,
  • Shramika Panchal,
  • Gokhan Yılmaz,
  • Juan de La Torre,
  • Dolores Verdoy,
  • Esteban de Manuel Keenoy,
  • Ane Fullaondo

摘要

This multicentre, non-randomized, quasi-experimental study evaluated the effectiveness of the ADLIFE digital toolbox—comprising clinical decision support, care-plan management, and patient empowerment—for patients aged >55 with chronic obstructive pulmonary disease and chronic heart failure. Across four pilot sites (Spain, UK, Denmark, and Israel), 185 patients received the intervention and were compared with 185 retrospective standard-of-care control matched using propensity score. The primary outcome was the number of emergency room (ER) visits, analyzed through multivariate hurdle regression. Results in the pooled analysis (N = 370) indicated that while ADLIFE was associated with a significant reduction in the likelihood of an initial ER visit (OR 0.55; 95% CI: 0.31–0.96), no significant differences were found for subsequent visits among patients who had already utilized emergency services (IRR 1.74; 95% CI: 0.88–3.43). Significant effect heterogeneity was observed, with a reduction achieved in only one location (AMCA: OR 0.30; 95% CI: 0.15–0.63). These findings suggest that while digitally enabled care models hold potential for initial acute care prevention, their effectiveness is heavily contingent upon complex contextual factors. Given the small sample size and site-specific results, these data should be interpreted with caution. Trial registration: ClinicalTrials.gov; NCT05575336; September 2022.