What did we do? 

In November 2020, the NHS England COVID Oximetry@home programme was launched to provide pulse oximeters for patients diagnosed with COVID-19. 

 

A pulse oximeter is a small medical device that is put on the tip of the finger, to check someone’s oxygen levels. Pulse oximeters measure blood oxygen levels by transmitting light through a finger. These allowed partients to monitor their oxygen at home and manage any risk of deterioration due to silent hypoxia (which is low oxygen levels in patients who do not show shortness of breath).

 

 

The COVID Oximetry@home pathway was made available to people who were:

 

• diagnosed with COVID-19: either clinically or positive test result and
• symptomatic and either
• aged 65 years or older or
• under 65 years and at higher risk from COVID-19, or where clinical judgement applied considering individual risk factors such as pregnancy, vaccination status, learning disability, caring responsibilities and/or deprivation. 
• pregnant women who were referred to a COVID Oximetry @home service should also have been asked to contact their maternity team for specific advice around pregnancy and COVID-19.

 

We used data from the Greater Manchester Care Record to evaluate whether COVID Oximetry@home was better than usual care in keeping people healthy and out of hospital. You can find out about other projects that use the Greater Manchester Care Record on the Rapid comparative evaluation webpage. 

 

 

Why was it important?

Previous evaluations of COVID Oximetry@home presented early evidence of benefits. However, it was not strong enough to make decisions about the use of COVID Oximetry@home in the future.

 

 

How did we do it?

We used data from the Greater Manchester Care Record to compare the outcomes of people who used COVID Oximetry@home with a matched group of patients with similar characteristics who did not use it.

 

 

Findings

The analysis of data collected between February 2020 and June 2022 reveals that:
 

• The odds for an “unplanned” admission following COVID-19 diagnosis were between 50% and 80% higher among CO@h patients compared to those who were not enrolled on the programme.
• The expected reduction in mortality among CO@h patients was estimated at two deaths per 1000 after 28 days, six at 90 days, and 10 after a year.
• The average length of stay for those admitted within 90 days of COVID-19 diagnosis was the same across both groups, at nine days.

While the analysis is encouraging, the research team believes more assessment is needed on factors such as cost-effectiveness and patient quality of life to ensure that pulse oximeters are an effective and efficient way to monitor and manage our health.
 

 

 

Who we worked with

• Health Innovation Manchester
• Greater Manchester Care Record

 

 

Downloadable resources

 

• Publications
  • Rubinstein F, Williams R, Dumville J, Kane B, Whittaker W, Bower P, Kontopantelis E. Patient use of pulse oximetry to support management of COVID-19 in Greater Manchester: A non-randomised evaluation using a target trial approach. Plos One (2024)
  • Shi, C, Goodall, M, Dumville, J et al. The accuracy of pulse oximetry in measuring oxygen saturation by levels of skin pigmentation: a systematic review and meta-analysis. BMC Med 20, 267 (2022).
• News stories
  • At-home blood oxygen monitors could prompt timely and life-saving treatment for COVID-19 patients (published November 2024)
  • Pulse oximeters may overestimate blood oxygen saturation for people with high levels of skin pigmentation in hospital settings compared with gold standard measures (published 2022)

 

 

More information

 

 

 

Programme Manager
Gill Rizzello
gill.rizzello@manchester.ac.uk