Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 17, 2019
Date Accepted: Mar 12, 2020
Evaluating an Intervention Program Using WeChat for Patients with Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial
ABSTRACT
Background:
Mobile health technology was used to implement home-based pulmonary rehabilitation intervention and management for Chronic obstructive pulmonary disease (COPD) patients. The development and implementation of this technology was combined with behavioral intervention strategy and telemedicine intervention model.
Objective:
Through the application of eHealth-enhanced chronic care model (eCCM), the functional module based on free social media WeChat Official Account (Pulmonary Internet explorer Rehabilitation, PeR) was developed, which was used to implement telemedicine pulmonary rehabilitation intervention and management for COPD patients. Then the improvement in symptoms, exercise self-efficacy and quality of life were evaluated.
Methods:
According to the eCMM components, eleven functional modules of PeR are developed by a multidisciplinary team. A total of 106 patients were randomly assigned [53 in the PeR group and 53 in the outpatient face-to-face group(FtF)]. We conducted pulmonary rehabilitation intervention for 3 months, then observed the prognosis for 3 months. The primary outcome was patients’ quality of life measured with COPD assessment test (CAT).
Results:
Intentionality analysis was used in the study. At the end of the third month, the Exercise self-regulatory efficacy scale (Ex-SERS) assessments of the PeR group was better than the FtF group (P = 0.03, P < 0.05), CAT and the modified British Medical Research Council scale (mMRC) of the two groups were higher than the baseline (P = 0.03, P = 0.00, P < 0.05); there was a negative correlation between CATand EX-SERS in the PeR group (r = -0.271, P = 0.05, P ≤ 0.05); there was no correlation between CAT and EX-SERS in the FtF group. At the end of the sixth month, the EX-SERS of the PeR group was lower than that of the third month (P = 0.10, P < 0.05), but there was no difference with that of the FtF group (P = 0.09, P > 0.05), The mMRC of the FtF group was better than that of the third month (P = 0.00, P < 0.05), but there was no difference with that of the PeR group(P = 0.21, P > 0.05); there was a negative correlation between CAT and EX-SERS in the PeR group (r = -0.349, P = 0.01, P < 0.05); there was a negative correlation between CAT and EX-SERS in the FtF group (r = -0.29, P = 0.04, P < 0.05).
Conclusions:
It is effective to develop telemedicine technology by using eCCM combined with behavioral intervention strategy. At the end of the third month, the self-efficacy of PeR group was better than that of FtF group. The symptoms and quality of life of the patients were improved. And the improvement was the same between the two groups. Clinical Trial: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900022770; http://apps.who.int/trialsearch/default.aspx
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