Can Wearable Tech Keep COPD Patients Out of the Hospital?

Can mobile technology help patients with chronic obstructive pulmonary disease (COPD) who may not seek care until they have an exacerbation? A recent study found a wearable device and a mobile device were considered useful by patients with COPD to help manage their condition, based on data from 26 adults who used the devices and systems. operation for 6 months.

Lifestyle options for COPD can improve quality of life and reduce hospitalizations, wrote Robert Wu, MD, assistant professor in the Department of Medicine at the University of Toronto, Toronto, Ontario, Canada and colleagues. However, information on the use of tools and equipment to manage COPD by providing reminders for self-care, predicting early exacerbations, and facilitating communication with health care providers is limited, they said.

In a study published in COPD: Journal of Chronic Obstructive Pulmonary Diseaseresearchers reported data from interviews with 26 older patients with COPD who used a device and a wearable app for 6 months to help manage their condition. The interviews were part of a larger group study.

“The motivation for this study was to understand the patient’s perspective on using clothing to help support their chronic lung condition,” Wu said in an interview. “People with COPD can be at high risk of being hospitalized, so it’s important to see if new technology like clothes or remote monitoring can help them,” he said.

People with COPD tend to be older and less tech-savvy, and may not be willing to use new technology, he added. “We wanted to understand what would make people use a self-care tool,” he said.

Upon enrollment in the study, patients received a smartwatch and smartphone with a pre-installed app for COPD management. The app included daily reminders to take medication, perform guided breathing sessions, check blood oxygen on a smartwatch or oximeter, and complete a symptom questionnaire. The app also allowed participants to record their workouts and provide feedback on heart rate and daily activity, including step count. Participants received stars for meeting daily exercise goals of active minutes and total steps.

Participants received training on the use of the app from members of the research team and completed a semi-structured interview after using the items for 6 months.

The researchers divided their findings into four main themes: Information, support and assurance; barriers to adoption; impact of communication with health care providers; and opportunities for improvement.

Overall, most patients reported that the feedback they received from the app was positive. In particular, participants reported that the app and smartwatch provided motivation and feedback on the importance of consistency during exercise, which encouraged others to stick to regular exercise routines. Almost two-thirds (65%) said the daily exercise reminders were encouraging. In addition, 20% reported that they interpreted vital data, including heart rate, as an indication of slowing down.

Participants rated medication reminders and the option to develop an action plan for COPD management as the least important aspects; 69% said they already have medication reminders.

A total of four patients experienced technical problems with the app that prevented it from affecting their disease management. Some of the suggestions from the participants for improvement included adding information about food intake, weight, blood pressure and temperature to the health information being tracked, as well as updating the scale of oxygen flow, which was disabled due to accuracy concerns. Disadvantages of using the device and app included the device’s bulk as well as reported inefficiencies.

The findings were limited by a number of factors, including a small sample size and possibly focusing on early adopters, which may not represent the majority of patients with COPD, the researchers noted. . Other limitations included the recruitment of many patients after the onset of the COVID-19 epidemic, which may have affected their experience and also limited the tool’s evaluation of communication with health care providers. , the researchers noted. This study did not address financial or social barriers.

However, the results suggest that patients with COPD have found potential value in wearable devices for disease management and that improved technology can promote patient empowerment and lifestyle changes, the researchers they decided.

Technology can increase attention and communication

“As doctors and researchers, we have ideas about what patients might want, but it’s always good to get their opinions on what they really want and what they will use,” Wu said. Medscape Medical News. “We thought that older people with COPD would not be able to interact with technology. We found that many want to have their data to help make connections with their condition, and some they bought smartwatches after the lesson to make these connections,” he said.

The takeaway from the current study is that people with COPD can benefit from self-management practices, but may prefer to use them in collaboration with their health care team, Wu said. “Doctors can see more of their patients bringing data from wearables and devices,” he said.

Concerns remain that using technology to help people with COPD may increase the “digital divide” and that those with low digital literacy, financial insecurity, or English as a second language they can be left behind, and it is important to always pay attention to equality. to pursue the use of tools and equipment, Wu told Medscape Medical News.

At first glance, research related to self-monitoring, remote monitoring and wearable devices has focused on certain conditions such as heart disease and diabetes, and more work is needed to examine whether these methods How technology can improve COPD patient care, Wu said. “We see this study as one important step – to understand what will motivate people to use personal care products and clothing,” he said.

“COPD exacerbations are critical events that can alter quality of life, lung function, and even mortality in COPD,” said Nathaniel Marchetti, DO, medical director of the Respiratory Intensive Care Center. Temple University Hospital, Philadelphia, in discussion. .

“Many of these complications go undiagnosed by nurses or patients until they arrive too late and end up in an urgent office visit with a doctor or in the emergency room. [ER]so dealing with exacerbations earlier has the potential to avoid ER visits or hospitalizations,” he said.

The study identified areas for further research, Marchetti said. “More data will be needed to determine whether the use of a device to monitor heart rate, symptoms and oxygen delivery can change important outcomes in COPD such as exacerbations,” he said.

As for limitations, “nobody wants to carry two smartphones,” Marchetti said. “The devices of the future should be easy to use and accessible on the patient’s phone,” he said. the current one also failed to deal with what will be done with the data collected, such as connecting them to health professionals who will provide treatment if necessary, he said.

Overall, data from the current study suggest that patients with COPD would like a device that monitors signs and vital signs and provides recommendations/recommendations for exercise and medication, Marchetti said. . Medscape Medical News. “A larger study will be needed that compares how such a device can improve the outcomes of COPD; the outcomes may include visits/visits to the ER, exercise, or medication compliance,” he said. In addition, clinical algorithms will be needed for the identification and treatment of COPD exacerbations, Marchetti said. These algorithms would decide whether treatment decisions would be initiated by a clinical team of health professionals or whether nurses would prescribe medications that patients would decide to take based on data collected in the app, using algorithms provided by the researcher.

The study was supported in part by Samsung Research America (SRA) and was developed by Wu with input from SRA, but the company had no part in the methods or results. This study was also supported by grants from the National Natural Science Foundation of China.

Marchetti had no relevant financial conflicts to disclose.