A Smartphone App Self-Management Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial of...

Area of Science:

• Digital health interventions
• Respiratory medicine
• Clinical trial research

Background:

• Chronic obstructive pulmonary disease (COPD) significantly impairs health outcomes, leading to exacerbations, hospitalizations, and reduced quality of life.
• Previous self-management programs show benefits, but limitations exist regarding intervention heterogeneity and study duration.
• Limited research has explored comprehensive smartphone app-based self-management for COPD over 12 months.

Purpose of the Study:

• To evaluate the effectiveness of a smartphone app self-management program, with or without monthly phone calls, compared to standard care for adults with COPD.
• To assess the impact on clinical health outcomes, including exacerbations, exercise capacity, and physical activity.

Main Methods:

• A 3-arm parallel pilot randomized controlled trial (RCT) involving 92 adult participants with COPD.
• Intervention groups received a self-management smartphone app (with or without monthly calls); the control group received standard outpatient care.
• Primary outcome: exacerbation-related general practitioner or hospital visits at 6 and 12 months. Secondary outcomes: engagement, breathlessness, physical activity, quality of life, and self-efficacy.

Main Results:

• The smartphone app (intervention arm 2) significantly reduced hospital exacerbations at 6 months (P=.03).
• Both intervention arms showed a significantly lower risk of exacerbations at GP and hospital settings at 6 months (P=.01 and P=.006, respectively).
• Intervention arm 1 improved exercise capacity (P=.02 and P=.03 at 6 and 12 months), while intervention arm 2 increased step count (P=.009). App usage was sustained by 60% of participants over 12 months.

Conclusions:

• Smartphone app-based self-management positively impacts clinical health outcomes in adults with COPD compared to standard care.
• Benefits include reduced exacerbations, fewer hospitalizations, improved exercise capacity, and increased physical activity.
• This pilot study supports a larger, multicenter trial to further investigate the efficacy of app-based COPD self-management.