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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Self-Management Support Using a Digital Health System Compared With Usual Care for Chronic Obstructive Pulmonary

Andrew Farmer1, Veronika Williams1, Carmelo Velardo2

  • 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

Journal of Medical Internet Research
|May 5, 2017
PubMed
Summary
This summary is machine-generated.

A digital health system (EDGE) did not improve COPD-specific health status in patients with moderate to very severe COPD. However, it showed benefits in generic health status, depression, and reduced hospital visits, warranting further research.

Keywords:
pulmonary disease, chronic obstructiverandomized controlled trialself-caretelehealth

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Area of Science:

  • Digital Health
  • Pulmonology
  • Clinical Trials

Background:

  • A randomized controlled trial evaluated a digital health system for community-based patients with moderate to very severe chronic obstructive pulmonary disease (COPD).
  • The system provided monitoring and self-management support to aid clinical care.

Purpose of the Study:

  • To determine the efficacy of the automated, internet-linked tablet system (EDGE) in improving quality of life and clinical outcomes for COPD patients.
  • To assess the impact of EDGE on COPD-specific health status and generic health status.

Main Methods:

  • A 12-month randomized controlled trial comparing daily EDGE use with usual care.
  • The primary outcome measure was COPD-specific health status using the St George's Respiratory Questionnaire for COPD (SGRQ-C).
  • Secondary outcomes included generic health status (EQ-5D), hospital admissions, and healthcare utilization.

Main Results:

  • No significant difference was found in COPD-specific health status (SGRQ-C) between the EDGE and usual care groups (difference -1.7, P=.49).
  • The EDGE group showed significantly better generic health status (EQ-5D) compared to usual care (difference 0.076, P=.03).
  • EDGE showed a trend towards reduced hospital admissions (RR 0.83, P=.37) and significantly fewer practice nurse visits (P=.03).

Conclusions:

  • The EDGE system did not demonstrate effectiveness in improving COPD-specific health status compared to usual care.
  • Benefits were observed in generic health status, with potential improvements in depression scores, hospital admissions, and general practice visits.
  • Further evaluation is warranted to explore the contribution of EDGE in supporting individuals with COPD.