Patients With COPD Pivot to Telemedicine During Pandemic

A study published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation found that more than half of respondents with chronic obstructive pulmonary disease (COPD) began using telemedicine since the beginning of the coronavirus disease 2019 (COVID-19) pandemic.

Additionally, respondents who had at least 1 exacerbation in during 2020 were more likely to use some form of telemedicine than respondents who did not experience any exacerbations (75.7% vs 54.3%, P < .001).

Individuals with COPD have a higher morbidity and mortality risk from COVID-19 than those without COPD. They also have a high risk of mortality and morbidity as a result of reducing or forgoing health care resource utilization, especially if their COPD exacerbations go untreated.

Telemedicine has the potential to be an effective tool for exacerbation prevention and management and allows for physicians to monitor patients with COPD during the vulnerable period following an exacerbation that resulted in hospitalization. Furthermore, digital health applications, such as the COPDF Pocket Consultant Guide, can act as a self-management and prevention tool, the authors said.

Researchers analyzed the results from 2 out of 3 online community surveys. The first survey didn’t address adoption of telemedicine and was excluded from the analysis.

The second survey was administered between April 26 and May 31, 2020 and the third was administered between August 14 and September 15, 2020.

Ninety-seven percent of respondents reported that they were on some form of respiratory medication for their COPD and 78% reported that they “avoid leaving the house” since the pandemic started.

A total of 157 out of 244 respondents (64%) said that they began using telemedicine in 2020. Forty-seven percent of participants experienced at least 1 exacerbation since the beginning of the year.

In addition to having higher rates of telemedicine adoption, respondents who had exacerbations in 2020 indicated higher instances of emergency health care avoidance since the pandemic began compared to those who did not have any exacerbations (27.8% vs 10.1%, P < .001).

Researchers said that there were no statistically significant differences in telemedicine adoption based on the population of where respondents lived, employment status, or use of supplemental oxygen.

Investigators noted that 15% of all participants reported that they would like assistance with using technology, video calls, and/or social media.

“While we are pleased to observe that a high percentage of our survey respondents seem to be following COPD treatment and COVID-19 prevention guidelines (based on medication use and social distancing responses), we are concerned about the inconsistency of telehealth approaches,” wrote researchers in their report.

Currently, 51% of COPD-related medical costs are covered by Medicare, however, telehealth services are not reimbursed for patients. Researchers said that future efforts are needed to inform policy changes to allow for patients to have full access to telehealth benefits and improve COPD management.

“We remain concerned about the quality, consistency, technological accessibility, and affordability of the telemedicine options available to the COPD community at large and accelerating the development of better digital tools remains a key focus of the COPDF,” wrote the authors in their report.

Reference

Boyce DM, Thomashow BM, Sullivan J, Tal-Singer R. Chronic Obstr Pulm Dis. Published online December 8, 2020. doi: 10.15326/jcopdf.2020.0181