Smart Mobile Health Tool May be Effective Alternative to Paper Action Plan for COPD

A smart mobile health tool that supports patients with chronic obstructive pulmonary disease (COPD) may be an effective alternative to a paper action plan for self-management of exacerbations, according to the results of a recent study published by JMIR Mhealth Uhealth.

The researchers conducted a 2-arm randomized controlled trial, which included an intervention group of patients with COPD using the smart mHealth tool, and a control group using a paper action plan when their respiratory symptoms were worsening.

“Self-management strategies, such as the use of a written exacerbation action plan, have been shown to improve exacerbation outcomes, that is, decrease exacerbation duration, reduce hospital admissions, and decrease the impact on health status,” explained the authors. “However, many patients do not adhere to the self-management instructions in their action plans when an exacerbation is imminent and thus do not get the benefit of the favorable health effects of timely detection and subsequent intervention.”

A telephone questionnaire system was used to measure weekly respiratory symptoms and treatment actions, as well as to measure exacerbation-free time. The study also considered health status, self-efficacy, self-management behavior, health care utilization, and usability.

In total, 87 patients with COPD were recruited from primary and secondary care centers and 43 were randomly selected to be in the intervention group. The researchers found no statistically significant differences between the intervention group and the control group in exacerbation-free weeks or in health status, self-efficacy, self-management behavior, and health care utilization. However, those who used the mHealth tool valued it more for support and usability than those with the paper action plan.

“The app was not designed to replace the health care professional but to reduce patient delay. Patients evaluated the app’s usability as good and as more supportive than the paper action plan,” concluded the authors. “Although this study did not show beneficial effects of the mHealth app compared with the use of a paper action plan, based on patient’s preference, it may be a valuable alternative to a paper action plan in the management of COPD.”

The researchers suggested that future research should focus on the patients who are interested in using digital tools in their daily life since they will be who benefits most from them.

Reference

Boer L, Bischoff E, van der Heijden M, et al. A smart mobile health tool versus a paper action plan to support self-management of chronic obstructive pulmonary disease exacerbations: Randomized controlled trial [published online September 10, 2019]. JMIR Mhealth Uhealth. doi: 10.2196/14408.