Comunicare and COPD : first results of a clinical study

LIÈGE, september 25th 2021 – Comunicare – First results of a feasibility and efficacy study of a simplified mobile application for self-education and self-monitoring for patients with severe chronic obstructive pulmonary disease in the Liège region – by Dr Jean-Baptiste Duquenne, under the supervision of Dr Hélène Van Cauwenberge

Background

In Belgium, an estimated 400,000 Belgians suffer from Chronic Obstructive Pulmonary Disease (COPD). A part of the burden comes from exacerbations, which lead to a deterioration in quality of life as well as a significant consumption of medical resources. The prevention of COPD exacerbations is helped by patient empowerment aided by education and self-management practices. It is in this context that telemedicine takes on its full meaning. It takes various forms, whether it be didactic, reinforcement of good practices, remote revalidation or home monitoring.

This telemonitoring is emphasised for the prevention of exacerbations. Promoting results are burdened by a too complicated follow-up of too complex computer tools.

Aims and methods

We want to create a simplified digital application “by the patient, for the patient” that is managed without the support of a health professional. The patient is responsible for himself. In our study, we evaluate the feasibility and effects of our digital health companion developed for a self-education and a self-management. We included patients with severe COPD, GOLD III to IV.

After the installation, the patient is invited to read the didactic part of the application. then, they complete the self-monitoring part at least three times a week but as many times as they wish. Scores and questionnaires are proposed at inclusion, at three and at six months, the duration of our study. The primary objective is to reduce the number of hospital admissions for COPD exacerbations, while the secondary objectives include, among others, an evaluation of quality of life and adherence to treatment.

Results

Due to the COVID19 pandemic lockdown, our recruitment was limited to 14 patients. The rate of encoding is excellent with no fatigue during the study. It is correlated with the feeling of ease of use of the application. The primary objective, to reduce the number of hospitalizations for COPD exacerbations, was not achieved. However, there is a positive correlation between the rate of encoding and some secondary objectives, such as the reduction of the number of days of hospitalisation, the CAT, and compliance with treatment. We note the increase in the anxiety-depression score.

Conclusion

The arrival of new technologies has allowed the development of telemedicine. Its use in COPD is promising but needs adjustment. The devices must be simple to use and are not suitable for all patients or situations. Motivated candidates will find it a reliable source of information as well as an aid to self-monitoring. It is particularly suitable for destabilising situations. Our study shows the feasibility of a digital companion that limits the complexity of the computer tool.