Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 28, 2024
Date Accepted: Oct 14, 2024
Efficacy and Acceptability of a Mobile Application for Monitoring the Clinical Status of Patients with Chronic Obstructive Pulmonary Disease Receiving Home Oxygen Therapy: A Randomized Controlled Trial
ABSTRACT
Background:
Chronic Obstructive Pulmonary Disease (COPD) primarily originates from exposure to tobacco smoke, although factors such as air pollution and exposure to chemicals also play a role. One of the primary treatments for COPD is oxygen therapy, which helps manage dyspnea and improve survival rates. Mobile health technologies (m-Health) have demonstrated significant potential in monitoring patients with chronic diseases, offering new avenues for enhancing patient care and disease management.
Objective:
The purpose of this study was to evaluate the efficacy and acceptability of a mobile application designed for the clinical monitoring of patients with COPD and home oxygen therapy, compared to conventional monitoring in real-world community settings.
Methods:
A parallel-group, non-blinded, multicenter randomized controlled trial was conducted with 45 participants: the intervention group, which used the mobile application in addition to conventional monitoring (n=23), and the control group, which received only conventional monitoring (n=22), administered by therapists over a duration of three months. The primary outcomes included the COPD Assessment Test (CAT) score, the level of dyspnea measured by the Borg scale, and oxygen saturation percentage, assessed at both the beginning and end of the trial. Secondary outcomes included the frequency of application use, the number of hospitalizations, and survival rates. Additionally, a satisfaction survey and an interview were conducted with the intervention group.
Results:
The median use of the mobile application was 21 days (Interquartile Range [IQR]: 12 days). At the end of the follow-up, the Borg dyspnea scale was significantly lower in patients who used the mobile application for home oxygen therapy monitoring (0.6 ± 0.8 vs. 4.1 ± 1.4; P = .001). Regarding the impact of COPD on quality of life, as measured by the COPD Assessment Test (CAT), no differences were found in the scores between baseline and end-of-follow-up within the control group. However, a significant decrease was observed in the intervention group (baseline median CAT: 27, IQR: 8 vs. final median CAT: 22, IQR: 14.3; P < .001). Additionally, the CAT score was significantly higher in patients receiving conventional monitoring compared to those monitored with the mobile application (median: 30, IQR: 9 vs. median: 22, IQR: 14.3; P = .02).
Conclusions:
The use of the mobile application AppO2, designed for the clinical monitoring of patients with COPD and home oxygen therapy, is associated with improved quality of life. Additionally, the application is highly accepted by users, promotes self-care, and fosters patient confidence in managing their own condition. Clinical Trial: ClinicalTrials.gov NCT04820790
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