Passive Monitoring of Short-Acting Beta-Agonist Use via Digital Platform in Patients With Chronic Obstructive Pulmonary Disease: Quality Improvement Retrospective Analysis.

Abstract

BACKGROUND:

Digital health programs assist patients with chronic obstructive pulmonary disease (COPD) to better manage their disease. Technological and adoption barriers have been perceived as a limitation.

OBJECTIVE:

The aim of the research was to evaluate a digital quality improvement pilot in Medicare-eligible patients with COPD.

METHODS:

COPD patients were enrolled in a digital platform to help manage their medications and symptoms as part of their routine clinical care. Patients were provided with electronic medication monitors (EMMs) to monitor short-acting beta-agonist (SABA) use passively and a smartphone app to track use trends and receive feedback. Providers also had access to data collected via a secure website and were sent email notifications if a patient had a significant change in their prescribed inhaler use. Providers then determined if follow-up was needed. Change in SABA use and feasibility outcomes were evaluated at 3, 6, and 12 months.

RESULTS:

A total of 190 patients enrolled in the pilot. At 3, 6, and 12 months, patients recorded significant reductions in daily and nighttime SABA use and increases in SABA-free days (all P<.001). Patient engagement, as measured by the ratio of daily active use to monthly active use, was >90% at both 6 and 12 months. Retention at 6 months was 81% (154/190). Providers were sent on average two email notifications per patient during the 12-month program.

CONCLUSIONS:

A digital health program integrated as part of standard clinical practice was feasible and had low provider burden. The pilot demonstrated significant reduction in SABA use and increased SABA-free days among Medicare-eligible COPD patients. Further, patients readily adopted the digital platform and demonstrated strong engagement and retention rates at 6 and 12 months.

• Authors: Jessica Chen, Leanne Kaye, Michael Tuffli, Meredith A Barrett, Shelanda Jones-Ford, Tina Shenouda, Rahul Gondalia, Kelly Henderson, Veronica Combs, David Van Sickle, David A Stempel
• Journal: JMIR formative research (JMIR Form Res) Vol. 3 Issue 4 Pg. e13286 (Oct 23 2019) ISSN: 2561-326X [Electronic] Canada
• PMID: 31647471 (Publication Type: Journal Article)
• Copyright: ©Jessica Chen, Leanne Kaye, Michael Tuffli, Meredith A Barrett, Shelanda Jones-Ford, Tina Shenouda, Rahul Gondalia, Kelly Henderson, Veronica Combs, David Van Sickle, David A Stempel. Originally published in JMIR Formative Research (http://formative.jmir.org), 23.10.2019.