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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Mar 12, 2020
Open Peer Review Period: Mar 12, 2020 - May 12, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Technology-enabled self-management of Chronic Obstructive Pulmonary Disease (COPD) with or without asynchronous remote monitoring: a randomized controlled trial

  • Vess Stamenova; 
  • Kyle Liang; 
  • Rebecca Yang; 
  • Katrina Engel; 
  • Florence van Lieshout; 
  • Elizabeth Lalingo; 
  • Angelica Cheung; 
  • Adam Erwood; 
  • Maria Radina; 
  • Allen Greenwald; 
  • Payal Agarwal; 
  • Aman Sidhu; 
  • R. Sacha Bhatia; 
  • James Shaw; 
  • Roshan Shafai; 
  • Onil Bhattacharyya; 

ABSTRACT

Background:

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and leads to frequent hospital admissions and emergency department (ED) visits. COPD exacerbations are an important patient outcome and reducing their frequency would result in significant cost savings. Remote monitoring and self-monitoring could both help patients manage their symptoms and reduce the frequency of exacerbations but they have different resource implications and have not been directly compared.

Objective:

The objective of our study was to compare the effectiveness of implementing a technology-enabled self-monitoring program (SM) versus a technology-enabled remote monitoring program (RM) in people with COPD compared to a standard care (SC) group.

Methods:

We conducted a 3-arm randomized controlled trial evaluating the effectiveness of a RM and a SM program relative to standard care. COPD patients were recruited from outpatient clinics and a pulmonary rehabilitation program. Patients in either intervention used a Bluetooth enabled device kit to monitor oxygen saturation, blood pressure, temperature, weight, and symptoms, but only patients in the RM group were monitored by a respiratory therapist. All patients were assessed at baseline, 3 and 6 months after program initiation. Outcomes included self-management skills, as measured by the Partners in Health (PIH) scale, patient symptoms measured with the St. George's Respiratory Questionnaire (SGRQ), and the Bristol COPD Knowledge Questionnaire (BCKQ). Patients were also asked to self-report on health system usage and data on health utilization was collected from the hospital.

Results:

A total of 122 patients participated in the study, 40 in the SC, 41 in the SM, and 41 in the RM groups. While all three groups improved in PIH, BCKQ scores and SGRQ Impact scores, there were no significant differences between any of the groups. No effects were observed on SGRQ Activity or Symptoms scores, or on hospitalizations, ED visits or clinic visits.

Conclusions:

Despite regular use of the technology, patients with COPD assigned to remote monitoring or self-monitoring did not have any improvement in patient outcomes like self-management skills, knowledge or symptoms or healthcare utilization compared to each other or to a standard care group. This may be due to low health utilization at baseline, the lack of structured educational components in the intervention groups, and the lack of integration of the action plan with the technology. Clinical Trial: ClinicalTrials.gov NCT03741855; https://clinicaltrials.gov/ct2/show/


 Citation

Please cite as:

Stamenova V, Liang K, Yang R, Engel K, van Lieshout F, Lalingo E, Cheung A, Erwood A, Radina M, Greenwald A, Agarwal P, Sidhu A, Bhatia RS, Shaw J, Shafai R, Bhattacharyya O

Technology-enabled self-management of Chronic Obstructive Pulmonary Disease (COPD) with or without asynchronous remote monitoring: a randomized controlled trial

JMIR Preprints. 12/03/2020:18598

DOI: 10.2196/preprints.18598

URL: https://preprints.jmir.org/preprint/18598

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