In a recent study published in the journal Telemedicine and eHealth, a team led by researchers from Temple University in Philadelphia showed that a digital health application for reporting chronic obstructive pulmonary disease (COPD) symptoms can facilitate early detection and treatment of disease exacerbations.
COPD is a lung disease characterized by reduced airflow, inflammation, and progressive worsening of disease symptoms. Even when COPD treatments are optimized, few patients are totally symptom free, and worsening symptoms (i.e., exacerbations) often lead to unscheduled office visits, emergency department interventions, and hospitalizations. Shortening the time from symptom onset to treatment reduces the severity of these events, but requires that patients recognize worsening symptoms, contact a healthcare provider, and start an appropriate treatment regimen. This process could be potentially facilitated through telemedicine.
In the study entitled “Use of a SmartPhone/Tablet-Based Bidirectional Telemedicine Disease Management Program Facilitates Early Detection and Treatment of COPD Exacerbation Symptoms,” the research team conducted a 320-day evaluation of 30 patients in terms of their compliance with daily COPD symptom reporting with the use of a digital health application. The ability of the Temple Lung Center to provide timely responses to worsening COPD symptoms, as reported by the digital application, was also evaluated.
The patient’s only responsibility was to report their symptoms on a daily basis. The application then compared the daily COPD symptom report with symptoms recorded when the patients are in their usual state of health. If worsening symptoms are detected, the application informs the patient and places an alert in the queue for review by a nurse.
“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 telemonitoring 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,” explained the study’s co-senior author and Director of the Temple Lung Center, Dr. Gerard J. Criner in a news 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.”
Results revealed that there were 4,434 symptom reports made over 5,178 patient-days of observation for an average reporting compliance of 85.6%. Median reporting compliance was 90.7% (interquartile range, 83.8–98%). Four hundred seventy-five symptom reports resulted in an alert. The average response time for all alerts was 6.64 hours.
“Early interventions for worsening COPD symptoms shortens their duration and reduces their severity,” said Michael R. Jacobs, PharmD, lead author of the study. “This digital health application is an example of how emerging technology can help facilitate early intervention and treatment by the health care team.”
From this quality assessment, researchers were able to conclude that patient adherence to the daily symptom reporting system exceeded 90% for over half of the participants. Furthermore, over 50% of worsening COPD symptom reports were responded to in less than 6 hours with patient-specific treatment recommendations.
The equipment used in the quality improvement program is an upgrade to the technology offered by HGE Health Care Solutions, a Temple University spin-off. HGE’s application is also supported by Temple’s Center for Digital Health.