Currently submitted to: Journal of Medical Internet Research
Date Submitted: Sep 1, 2019
Open Peer Review Period: Sep 1, 2019 - Oct 27, 2019
(currently open for review)
Using mobile health technology to deliver a community based closed-loop management system for chronic obstructive pulmonary disease
Mobile health (mHealth) technology is an increasingly recognized and effective way for disease control and management, which has the potential to intervene in exacerbation risk, psychology and lung function of chronic obstructive pulmonary disease (COPD) patients.
This study aimed to investigate a community based closed-loop COPD management system suitable for Chinese remote area with many potential COPD patients but limited medical resources.
A mHealth-based COPD management system is designed and architected and then three methods, COPD Evaluation, Psychological Intervention and Closed-Loop Care Pathway are proposed to evaluate and manage stable COPD patients. Total of 39 patients finished the whole 6 months procedure and were included in the analyses.
During the study period, 459 exacerbations were detected (Mean 11.8, SD 22.9, 95% CI 4.6 to 19.0), of which 84.5% were dealt with through our system. Thus, both hospitalization and clinic visit due to acute exacerbation per year dropped significantly (p<.001, p=.006 respectively). And psychological condition significantly improved, especially depression condition measured by PHQ-9 scale (p=.003).
It is feasible and eligible in area with limited medical resources to implement a mHealth based method for COPD management in community level. After 6-month management, the reduction of hospitalization and clinic visits was statistically significant. Pulmonary function and COPD-specific symptoms were not improved, but psychological distress was significantly reduced, where the assistant of WeChat might play an important role.
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