An App Platform-Facilitated Collaborative Palliative Care Intervention for Outpatients With Interstitial Lung...

Area of Science:

• Pulmonology
• Palliative Care
• Digital Health

Background:

• Outpatients with interstitial lung disease (ILD) often have serious symptoms but limited access to palliative care.
• Advance care planning and palliative care discussions are crucial for managing serious illness.
• Mobile health applications offer potential for improving patient engagement in care.

Purpose of the Study:

• To assess the feasibility and clinical impact of a mobile application (PCplanner) for delivering palliative care principles to outpatients with ILD.
• To evaluate the app's effect on patient-reported needs and advance care planning behaviors.

Main Methods:

• A pilot randomized controlled trial was conducted with adult ILD outpatients.
• Participants were randomized to receive standard care or care augmented by the PCplanner mobile application.
• Outcomes included feasibility metrics (randomization, retention), changes in the Needs at the End-of-Life Screening Tool (NEST) scores, and frequency of advance care planning discussions/referrals.

Main Results:

• Feasibility benchmarks for randomization (82.1%) and retention (84.8%) were met.
• No significant difference was observed in the primary outcome (change in NEST scores from baseline to 3 months) between the intervention and control groups (P = 0.481).
• Patients in the intervention group were more likely to update advance directives and code status compared to the control group.

Conclusions:

• The PCplanner mobile application is feasible for use in an outpatient ILD setting.
• While not impacting self-reported symptom burden significantly, the app facilitated advance care planning documentation.
• Mobile health interventions show promise for enhancing palliative care engagement in chronic lung diseases.