App Aids COPD Exacerbation Detection and Treatments

A digital health application can facilitate early detection and treatment of symptoms of chronic obstructive pulmonary disease (COPD) exacerbations, according to findings published in Telemedicine and eHealth.

Researchers from Temple University Health System observed 30 patients given a smart phone application for reporting their COPD symptoms in order to evaluate if goals of facilitating detection of symptoms and treatment were working.

The reports were taken between November 2012 and September 2013 and reviewed by their timestamp. In total, there were 4434 symptom reports made over 5178 patient days. The researchers calculated adherence using the number of reports made divided by the number of days enrolled in the program for each patient.

The time to intervention was defined as the time a report was submitted to the time a treatment recommendation was sent to the patient.

The observation average reporting compliance was 85.6%. The median reporting compliance was 90.7%. A total of 475 symptom reports resulted in an alert being sent out. For all the alerts, the average response time was 6.64 hours, with a median response time of 5.75 hours.

“Given a general lack of awareness among patients of small day to day symptom changes and the pace of symptom worsening in COPD, daily COPD tele-monitoring is an attractive approach to facilitate early intervention, provided that the system is used and that the health care provider responds in a timely manner,” study leader Gerard J. Criner, MD, FACP, FACCP, explained in a press release. “Patient adherence to daily symptom reporting system using this application exceeded 90% for more than half of the participants, and 90% of worsening COPD symptom reports were responded to in less than 11 hours with patient specific treatment recommendations. That’s substantially better than response times reported in recent COPD research literature.”

The limitations of the study described by the researchers include a small patient sample, very ill patients, and a lack of a control group, which limited the follow up duration. The team is still unable to comment on whether health care utilization was impacted.

They added that the app used in the quality improvement program, from which the original patients were recruited, is a precursor to the solution offered by HGE Health Care Solutions, a spinoff company of Temple University.

“Early interventions for worsening COPD symptoms shortens their duration and reduces their severity,” lead author Michael R. Jacobs, PharmD, added in the statement. “This digital health application is an example of how emerging technology can help facilitate early intervention and treatment by the health care team.”