A new feasibility study has found that an app supporting self-managed care for people with chronic obstructive pulmonary disease (COPD) may help reduce exacerbations.
New research has found that people with COPD may benefit from the use of a self-management app.
The feasibility study, which appears in the journal npj Digital Medicine, lays the groundwork for future studies. The next steps will be to confirm the initial findings and develop a better understanding of the mechanisms behind the promising results.
According to the Centers for Disease Control and Prevention (CDC), COPD describes a number of diseases, which include emphysema and chronic bronchitis. In these conditions, the airways become blocked, which results in the person having difficulty breathing.
Approximately 15.7 million people in the United States — equating to roughly 6.4% of the population — have received a diagnosis of COPD.
Smoking is a key cause of COPD, but research has also linked the condition to respiratory infections and exposure to air pollutants, as well as genetic factors.
COPD can have a significant negative effect on an individual’s life. It can cause difficulty moving around, including climbing stairs, and can impair a person’s ability to work and socialize. Experts have also linked COPD to mental health issues, including depression.
One of the challenges for health services working with people with COPD is the high rate of readmission following treatment in the hospital.
The authors of the present study note that people with COPD typically receive treatment in the hospital when they experience an “acute crisis” — for example, a sudden worsening of their symptoms. Following the resolution of the acute crisis, the hospital normally discharges the individual.
However, this can leave little time for healthcare professionals to support the person and address the underlying factors that caused the acute crisis in the first place.
Research has shown that giving people the tools to self-manage their COPD while at home can reduce their rate of readmission to the hospital. However, giving this support can be beyond the resources available to many publicly funded hospitals.
As a consequence, the authors of the present study wanted to see whether a COPD self-management app could offer this support.
To begin to explore this, the authors conducted a feasibility study. At a National Health Service (NHS) site in the United Kingdom, they approached 124 people who were admitted to hospital due to COPD between June and December 2015.
Of these people, 41 agreed to take part in the study. The researchers randomly assigned each participant to one of two groups. Those in the first group received standard written self-management advice, while the other group had access to the myCOPD app.
The team monitored both groups for 3 months.
The myCOPD app contains educational information and advice to help people manage their COPD, including a 6-week pulmonary rehabilitation program, videos demonstrating good inhaler technique, and environmental alerts for pollution and the weather. It also enables healthcare professionals to monitor a person’s health remotely.
The researchers found that COPD exacerbations were almost half as common in the group who received access to the myCOPD app than in the group receiving treatment as usual. They reported 18 exacerbations for the myCOPD group rather than 34 for the control group.
The myCOPD users also had significant improvements in inhaler technique compared with the control group, seeing an 80% drop in incorrect use compared with a 28% drop in the control group.
While these results are encouraging, it is important to note that this was a small feasibility study.
Furthermore, the study did not determine what might be driving the positive results and how applicable they might be to other people with COPD.
For example, the authors note that of the 124 people whom they invited to take part in the study, 66 declined without offering any reason.
If a significant number of these people were put off by the use of digital technology, it may be that the results would not be as promising if the app were made obligatory for all COPD patients — whether they were comfortable using digital technology or not.
Nonetheless, the study makes it clear that a self-management app may be a worthwhile focus for future research.
As Prof. Tom Wilkinson of the University of Southampton, U.K., who developed the app and led the trial, notes, “The transition toward digital healthcare has been taking place for some time but has accelerated since the outbreak of COVID-19.”
“Patients with conditions such as COPD can be particularly vulnerable now, so it is important that we have evidence of the effectiveness of these technologies.”
– Prof. Tom Wilkinson
“Hopefully, the success of this will lead to further use and the development of similar products that allow patients to manage other conditions to further improve their well-being and reduce the burden on the NHS,” Prof. Wilkinson concludes.
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