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Oximetry-supported self-management for chronic obstructive pulmonary disease: mixed method feasibility pilot project
Michele MacNab1, Siew Hwa Lee2, Lucy McCloughan3
1e-Health Research Group, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK. Michele.McNab@ed.ac.uk.
BMC Health Services Research
|October 28, 2015
Summary
The "Light Touch" service, using pulse oximetry for COPD self-monitoring, showed promise in empowering patients. While improving anxiety and depression scores, it had limited helpline contact, suggesting potential for reduced clinical supervision.
Area of Science:
- Respiratory Medicine
- Digital Health
- Patient Self-Management
Background:
- Pulse oximetry offers potential for enhanced patient self-monitoring in chronic respiratory conditions.
- The 'Light Touch' service in NHS Lothian utilized a self-management plan for COPD patients incorporating symptom tracking and oximetry readings.
- Community respiratory teams provided oversight and a helpline for patient support within the service.
Purpose of the Study:
- To evaluate the feasibility of the 'Light Touch' service for COPD self-management.
- To assess the perceived utility and impact of the service on patients and healthcare professionals.
- To determine the effectiveness of oximetry-guided self-management in COPD patients.
Main Methods:
- A before-and-after study design was employed, comparing quantitative data (SGRQ, HADS, healthcare resource use) over a 6-month period.
- Qualitative data were gathered through semi-structured interviews with patients, managers, and a focus group with healthcare professionals.
- Thematic analysis was used to interpret qualitative data, exploring perceptions of the service and self-management strategies.
Main Results:
- 46 participants completed the study; 46% showed clinically significant improvement in St George's Respiratory Questionnaire (SGRQ) scores, while 26% deteriorated.
- Anxiety and depression scores improved, with more participants achieving normal scores at 6 months compared to baseline.
- Despite potential benefits, only 39% of participants contacted the helpline, and healthcare professionals noted concerns about low patient engagement with support teams.
Conclusions:
- The 'Light Touch' service demonstrates potential as a cost-effective approach to enhance patient self-management skills in COPD.
- The service may reduce the need for intensive clinical supervision by empowering patients through oximetry-guided self-monitoring.
- Further research is needed to optimize patient engagement and support mechanisms within such self-management programs.
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