JMIR Publications

ABSTRACT

Background:

Continuous remote monitoring of physiological parameters and symptom changes, facilitated by commercially available wearables, Bluetooth home spirometry, and smartphone apps, offers the potential for timely interventions, improved patient outcomes, and reduced healthcare costs.

Objective:

This study aims to investigate whether remote monitoring is feasible and acceptable to patients with chronic respiratory diseases.

Methods:

In this three-arm prospective observational cohort feasibility study (ISRCTN registration number: ISRCTN16275601), 60 patients were recruited from the Royal Free London Hospital and University College London Hospital with: ILD, COPD, and post-COVID-19 (n=20 per group) and followed for six months. Data were collected using REDCap periodic surveys, RADAR-base active app questionnaires, wearables, finger oximeters, smartphone apps, and Bluetooth home spirometry. The feasibility of remote monitoring was measured by adherence to the protocol, engagement during the time of follow-up, retention rate, acceptability, and data integrity.

Results:

Passive data collection methods, via wearables, demonstrated superior adherence, engagement and retention compared to active data collection methods, with an average usage of the wearables recorded at 18.66 ± 4.69 hours daily (77.8% of the day), 123.91 ± 33.73 hours weekly (72.6% of the week), and 463.82 ± 156.70 hours monthly (64.4% of the month). Spirometry and high-burden active tasks had the lowest adherence, engagement, and retention, followed by questionnaires. Adherence rate of home spirometry was 59%. Of these, 90% were of acceptable quality according to ATS grading. There were significant differences in the retention of patients who took protocol holidays and those who did not in the COPD and ILD cohorts. The technologies used were found to be easy to learn (80%), easy to manipulate (64%), useful (83%), productivity-increasing (64%) and helpful (79%).

Conclusions:

Our findings provide evidence supporting the feasibility and acceptability of remote monitoring in capturing both subjective and objective data from varied sources for respiratory diseases. The high engagement level observed with passively collected data suggests the potential of wearables for long-term, user-friendly remote monitoring in respiratory disease management. The unique piloting of certain features such as protocol holidays, assistive for long-term follow-up, and flexible support from the study team provides a reference for future studies in this field.   Clinical Trial: The study was registered with ISRCTN: 16275601Ethics approval was given and patients provided written informed consent.