Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention
Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s44247-024-00142-4 |
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| author | Laurel O’Connor Stephanie Behar Seanan Tarrant Pamela Stamegna Caitlin Pretz Biqi Wang Brandon Savage Thomas Scornavacca Jeanne Shirshac Tracey Wilkie Michael Hyder Adrian Zai Shaun Toomey Marie Mullen Kimberly Fisher Emil Tigas Steven Wong David D. McManus Eric Alper Peter K. Lindenauer Eric Dickson John P. Broach Vik Kheterpal Apurv Soni |
| author_facet | Laurel O’Connor Stephanie Behar Seanan Tarrant Pamela Stamegna Caitlin Pretz Biqi Wang Brandon Savage Thomas Scornavacca Jeanne Shirshac Tracey Wilkie Michael Hyder Adrian Zai Shaun Toomey Marie Mullen Kimberly Fisher Emil Tigas Steven Wong David D. McManus Eric Alper Peter K. Lindenauer Eric Dickson John P. Broach Vik Kheterpal Apurv Soni |
| author_sort | Laurel O’Connor |
| collection | DOAJ |
| description | Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations. Results Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30–210) and 18.9 h/day (IQR16-20) resulting in a median of 1034 min/day (IQR 939–1133). The rate at which participants completed scheduled survey instruments ranged from 78–93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p = 0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures. Conclusions A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life. Trial Registration The study is registered at Clinicaltrials.gov NCT06000696 (Registered on 08/14/2023). |
| format | Article |
| id | doaj-art-81597917bcdf4429af46ea5460ce0092 |
| institution | Kabale University |
| issn | 2731-684X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Digital Health |
| spelling | doaj-art-81597917bcdf4429af46ea5460ce00922025-01-19T12:39:36ZengBMCBMC Digital Health2731-684X2025-01-013111310.1186/s44247-024-00142-4Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation interventionLaurel O’Connor0Stephanie Behar1Seanan Tarrant2Pamela Stamegna3Caitlin Pretz4Biqi Wang5Brandon Savage6Thomas Scornavacca7Jeanne Shirshac8Tracey Wilkie9Michael Hyder10Adrian Zai11Shaun Toomey12Marie Mullen13Kimberly Fisher14Emil Tigas15Steven Wong16David D. McManus17Eric Alper18Peter K. Lindenauer19Eric Dickson20John P. Broach21Vik Kheterpal22Apurv Soni23Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolCareEvolution, Limited Liability CompanyDepartment of Community Medicine and Family Health, University of Massachusetts Chan Medical SchoolOffice of Clinical Integration, University of Massachusetts Memorial HealthcareOffice of Clinical Integration, University of Massachusetts Memorial HealthcareProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolDivision of Pulmonary, Critical Care Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolDivision of Pulmonary, Critical Care Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolDivision of Health System Science, University of Massachusetts Chan Medical SchoolDivision of Pulmonary, Critical Care Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolDivision of Health Informatics and Implementation Science, Department of Population and Quantitative Health SciencesProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolDepartment of Healthcare Delivery and Population Sciences and Department of Medicine, University of Massachusetts Chan Medical School–BaystateProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolCareEvolution, Limited Liability CompanyProgram in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical SchoolAbstract Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations. Results Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30–210) and 18.9 h/day (IQR16-20) resulting in a median of 1034 min/day (IQR 939–1133). The rate at which participants completed scheduled survey instruments ranged from 78–93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p = 0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures. Conclusions A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life. Trial Registration The study is registered at Clinicaltrials.gov NCT06000696 (Registered on 08/14/2023).https://doi.org/10.1186/s44247-024-00142-4Chronic obstructive pulmonary diseaseDigital healthRemote monitoringMobile integrated healthCommunity paramedicineCommunity health |
| spellingShingle | Laurel O’Connor Stephanie Behar Seanan Tarrant Pamela Stamegna Caitlin Pretz Biqi Wang Brandon Savage Thomas Scornavacca Jeanne Shirshac Tracey Wilkie Michael Hyder Adrian Zai Shaun Toomey Marie Mullen Kimberly Fisher Emil Tigas Steven Wong David D. McManus Eric Alper Peter K. Lindenauer Eric Dickson John P. Broach Vik Kheterpal Apurv Soni Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention BMC Digital Health Chronic obstructive pulmonary disease Digital health Remote monitoring Mobile integrated health Community paramedicine Community health |
| title | Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention |
| title_full | Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention |
| title_fullStr | Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention |
| title_full_unstemmed | Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention |
| title_short | Healthy at home for COPD: an integrated digital monitoring, treatment, and pulmonary rehabilitation intervention |
| title_sort | healthy at home for copd an integrated digital monitoring treatment and pulmonary rehabilitation intervention |
| topic | Chronic obstructive pulmonary disease Digital health Remote monitoring Mobile integrated health Community paramedicine Community health |
| url | https://doi.org/10.1186/s44247-024-00142-4 |
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