The use of Propeller Health’s digital health program, which integrates real-time data from chronic obstructive pulmonary disease (COPD) patients and feedback from healthcare providers, had a significant improvement on health outcomes, a new study shows.
The study, “Passive Monitoring of Short-Acting Beta-Agonist Use via Digital Platform in Patients With Chronic Obstructive Pulmonary Disease: Quality Improvement Retrospective Analysis,” was published in JMIR Formative Research.
Short-acting beta-agonists (SABA) are prescribed to patients with COPD to manage acute symptoms because they provide quick relief of symptoms; as such, SABA are considered rescue medications.
If physicians had access to data about patients’ actual use of SABA, they potentially could adjust the medication regimen, identify worsening symptoms, and determine the risk or occurrence of a disease exacerbation.
This has led to the development of smartphone apps, electronic medication monitors, and text-based interventions that can track and provide real-time feedback on medication use and clinical status.
Such digital health programs have been successful for treating chronic respiratory diseases, including asthma and COPD. However, these programs often are associated with non-engagement and eventual abandonment by patients.
New research suggests that digital health programs that also integrate healthcare providers (such as physicians) or human coaches may improve clinical outcomes, rates of engagement, and retention.
“COPD can have a devastating impact on the people it affects. The use of a digital health tool to manage COPD can lift some of the burden of the disease, and go a long way in improving day-to-day quality of life, particularly when clinicians and patients engage together with the data,” Meredith Barrett, PhD, vice president of research at Propeller Health, said in a press release.
However, there has been little effort to enroll COPD patients in these programs due to perceived challenges with patient age and comfort with technology, as well as potential increases in provider burden.
So, a group of researchers from Propeller Health and the JenCare Senior Medical Center clinics in Louisville, Kentucky, conducted a pilot study to determine whether a digital health program that integrates healthcare providers could help improve the clinical outcomes in Medicare-eligible COPD patients.
In total, 190 COPD patients were recruited from three JenCare Senior Medical Center clinics.
Patients were provided access to Propeller’s digital health tool, which works by attaching a small sensor (an electronic medication monitor) to the patient’s inhaler in order to collect data on medication use, namely SABA. A smartphone app was used to track trends and receive feedback.
The system then sends medication reminders, progress reports, and disease insights to the patients’ smartphones or hubs, as well as reports to their healthcare providers. Providers had access to the data collected through a secure website, and were sent email notifications if a patient had a significant change in their inhaler use.
Changes in SABA use and outcomes were evaluated at three, six and 12 months. Physicians used real-time data from Propeller to recommend adjustments to patients’ personalized care plans.
Results indicated that at three, six and 12 months, patients recorded significant reductions in daily and nighttime rescue use of SABA, and an increase in the number of days in which they did not need SABA (a 36% increase at 12 months), which suggested that their overall condition had improved.
Patient engagement — measured by the ratio of daily active use to monthly active use — was greater than 90% at both six and 12 months. Furthermore, patients readily adopted the digital platform and had a retention rate of 81% at six months.
On average, healthcare providers were sent two email notifications per patient during the 12-month period.
Overall, the results suggested that “a digital health program integrated as part of standard clinical practice was feasible and had low provider burden. The pilot demonstrated significant reduction in SABA use, and increased SABA-free days. … Further, patients readily adopted the digital platform, and demonstrated strong engagement,” the researchers wrote.
Jessica Chen, MD, chief quality officer at ChenMed, owner of JenCare Senior Medical Centers, said: “This program was able to minimize the burden on providers while maximizing patient engagement in their own care, leading to significantly better outcomes and a stronger alliance between patient and provider.”
“Propeller helped COPD patients partner with their providers to better understand and manage their condition,” Chen said.