A novel web-based application for supported self-management of Chronic Obstructive Pulmonary Disease (COPD)
Chronic Care and Patient-Centred Care
Self-management is a key component of evidence-based care for patients living with Chronic Obstructive Pulmonary Disease (COPD). Mobile-based applications with patient-specific information may support COPD patients in learning self-management skills, including adherence to inhaled medications, proper inhaler technique, and early identification and treatment of acute exacerbations. An Android application, MedlyCOPD, was developed by the Centre for Global eHealth Innovation and the Asthma and Airway Centre. Features of the app included a tailored list of COPD medications, reminders to aid in adherence to a regular medication schedule, and links to inhaler technique videos. The app also incorporates daily symptom tracking as a tool for early identification of acute exacerbations of COPD, and prompts to initiate a customized action plan when an acute exacerbation is identified.
COPD is a common chronic disease associated with high hospitalization rates, financial burden and decreased quality of life. Appropriate patient self-management improves disease control and reduces healthcare use. Development of these skills is limited during infrequent clinic visits but new information technologies provide innovative avenues for providing support for self-care and clinical management of COPD. This project involved the user-centred design and development of an Android application, MedlyCOPD.
A feasibility study (REB #14-7756-AE) was conducted to evaluate the ease of use amongst both patients and clinicians; impact on COPD-specific patient knowledge, self-efficacy, and health-related quality of life; and rates of medication adherence, exacerbations, and acute care visits. We enrolled a total of 13 participants out of a target of 15 participants, with a target study participation of 6 months. Rates of adherence with the app and use of the different features (eg, log-in, daily symptom reporting, action plan initiation, accessing training videos) were measured.
The through-traffic, drop-off rates, and number of unique sessions were examined in order to track adherence and feature usage patterns. On average, patients had a daily log-in and adherence rate of 56.2% over the six-month trial period. The main user goal appears to have been to complete the symptom questionnaire and receive their action plan as the majority of users dropped off of the app after these tasks without using other features of the app. Several hypothesis that are currently being investigated to sustain engagement with the app including the presentation of the features at the time of enrollment and revisiting patient selection.