JMIR Publications

ABSTRACT

Background:

Digital health programs assist patients with chronic obstructive pulmonary disease (COPD) to better manage their disease. Technological and adoption barriers have been perceived as a limitation.

Objective:

The aim was to evaluate a digital quality improvement pilot in Medicare-eligible patients with COPD.

Methods:

COPD patients were enrolled in a digital platform to help manage their medications and symptoms as part of their routine clinical care. Patients were provided with electronic medication monitors to monitor short-acting beta-agonist (SABA) and controller inhaler use passively, and a self-management platform to track usage trends and receive feedback. Providers also had access to data collected and were sent e-notifications if a patient had a significant change in their prescribed inhaler use. Providers then determined if follow-up was needed. Clinical and feasibility outcomes were evaluated at 3, 6 and 12 months.

Results:

One hundred and ninety patients enrolled in the study. At 3, 6 and 12 months, patients recorded significant reductions in daily SABA use, nighttime SABA use, as well as an increase in SABA-free days (all p<0.001). Patient engagement, as measured by the ratio of daily active to monthly active use, was >90% at both 6 and 12 months. Retention at 6 months was 81% (n=154). Providers were sent on average two e-notifications per patient during the 12-month program.

Conclusions:

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 SABA-free days among Medicare-eligible COPD patients. Further, patients readily adopted the digital platform and demonstrated strong engagement and retention rates at 6 and 12 months. Clinical Trial: NA