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

10.2196/13286 ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. e13286 ◽  
Author(s):  
Jessica Chen ◽  
Leanne Kaye ◽  
Michael Tuffli ◽  
Meredith A Barrett ◽  
Shelanda Jones-Ford ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Improvement ◽  
Pulmonary Disease ◽  
Digital Health ◽  
Beta Agonist ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short Acting ◽  
Digital Platform ◽  
Copd Patients

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.

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

2019 ◽  
Author(s):  
Jessica Chen ◽  
Leanne Kaye ◽  
Michael Tuffli ◽  
Meredith A Barrett ◽  
Shelanda Jones-Ford ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Quality Improvement ◽  
Pulmonary Disease ◽  
Digital Health ◽  
Beta Agonist ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short Acting ◽  
Digital Platform ◽  
Copd Patients

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 <italic>P</italic>&lt;.001). Patient engagement, as measured by the ratio of daily active use to monthly active use, was &gt;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.

An Integrated, Multimodal, Digital Health Solution for Chronic Obstructive Pulmonary Disease: A Prospective Observational Pilot Study (Preprint)

2021 ◽  
Author(s):  
Brian D Gelbman ◽  
Carol R Reed
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Patient Satisfaction ◽  
Pilot Study ◽  
Pulmonary Disease ◽  
Pulse Oximeter ◽  
Digital Health ◽  
Medication Use ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

BACKGROUND Chronic obstructive pulmonary disease (COPD) affects millions of Americans and has a high economic impact partially due to frequent Emergency Room (ER) visits and hospitalizations. Advances in digital health have made it possible to collect data remotely from multiple devices to assist in managing chronic diseases such as COPD. OBJECTIVE In this study, we evaluated the ability of COPD patients to use the Wellinks® mHealth platform to collect information from multiple modalities important to the management of COPD. We also assessed patient satisfaction and engagement with the platform. METHODS A single-site, observational, prospective pilot study (N=19) was conducted using the Wellinks platform in adults with COPD. All patients were > 30 years old at screening, owned an iPhone, and were currently undergoing a treatment regimen that included nebulized therapy. Enrolled patients received a study kit consisting of the FlypTM nebulizer, Smart One spirometer, the Nonin® pulse oximeter, plus the Wellinks mHealth application and training for all devices. For 8 weeks, participants were to enter daily symptoms and medication use manually; spirometry, nebulizer and pulse oximeter data were automatically recorded. Data was sent to the attending physician in a monthly report. Patient satisfaction was measured via a 5-point scale and the Net Promoter Score (NPS) captured in interviews at the end of the observation period. RESULTS Average age of the patients was 79.63 (range 65–95) years old. Participants (10 female; 9 male) had an average FEV1% of 56.22% predicted (range 23-113) and FEV1/FVC of 65%. COPD severity, as assessed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, was mild in 2 patients, moderate in 6, and severe/ very severe in 11; 9 patients were on home oxygen. During this 8-week study, average use of the spirometer was 2.52 times/week, and the pulse oximeter 4.24 times/week. Medication use was manually documented 9.04 times/week, nebulizer use 1.93 times/week, and symptoms recorded 1.15 times/week on average. The correlation coefficients of home to office measurements for peak flow and FEV1 were high (r=0.94 and 0.96, respectively). Patients found the app valuable (82%) and easy to use (94%). The NPS was 59. CONCLUSIONS This study demonstrates that our cohort of COPD patients engaged with the Wellinks mHealth platform avidly and consistently over the 8-week period, and that patient satisfaction was high, as indicated by satisfaction survey and the NPS of 59. Regardless of disease severity, age, or gender, patients were both willing to use the technology and capable of doing so successfully. The Wellinks mHealth platform was considered useful and valuable by patients, and can assist clinicians in improved, timely decision-making for better COPD management.

scholarly journals Results of long-term treatment with short-acting bronchodilators of patients with chronic obstructive pulmonary disease (COPD) and COPD combined with asthma

2005 ◽  
pp. 101-106
Author(s):  
E. I. Shmelev ◽  
M. A. Khmelkova ◽  
Z. O. Grineva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Term Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short Acting ◽  
Copd Patients ◽  
Long Term Treatment

This study was designed to investigate long term treatment effects of short acting bronchodilators on respiratory symptoms, lung function, and the mean pulmonary artery pressure (mPAP) in patients with chronic obstructive pulmonary disease (COPD) and COPD combined with asthma (COPD + BA). The study involved 14 COPD patients and 16 COPD+BA patients, males and females (the average age, 60 yrs) with moderate to severe disease and the mPAP higher than 20 mm Hg. Clinical examination with scoring of cough, sputum, dyspnea, and lung auscultation signs; spirometry, ECG, echocardiography, chest X ray, and blood analysis were used. Clinical status and lung function were evaluated primarily and in 4, 12, and 24 wks; the mPAP was measured initially and in 12 and 24 wks. Before the study no one patient received persistent supporting therapy with bronchodilators, 15 COPD + BA patients and 7 COPD patients were given inhaled steroids. Persistent therapy of all the patients with Berodual 2 doses 4 times daily for 24 wks resulted in improvement in the clinical symptoms and lung function parameters, reduction in mPAP in both the groups but the results were better and they were reached faster in the patients with combined pathology. Thus, the regularly combined therapy with short acting β2 agonists and anticholinergics (Berodual) can be included in the algorithm of therapy of pulmonary hypertension in patients with COPD and COPD + BA.

scholarly journals Clinical, instrumental and pharmacological comparisons of patients with chronic obstructive pulmonary disease (COPD) and asthma in real clinical practice

2019 ◽  
Vol 29 (4) ◽  
pp. 448-455
Author(s):  
I. Yu. Vizel’ ◽  
I. N. Salakhova ◽  
A. R. Vafina ◽  
A. A. Vizel’ ◽  
N. M. Rakhmatullina ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Status ◽  
Laboratory Data ◽  
Clinical Signs ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Short Acting ◽  
Copd Patients ◽  
Asthma Patients

The objective of this study was to compare demographic, clinical, functional, laboratory data, and therapy in patients with chronic obstructive pulmonary disease (COPD) and asthma who seek for medical aid at medical institutions of Kazan’. Methods. The study involved 153 patients with COPD aged 33 to 89 years and 229 patients with asthma aged 18 to 87 years. Clinical status, rate of exacerbations, spirometric data, treatment and compliance during the previous year were analyzed. Statistical analysis was performed using the SPSS-18 software. Results. COPD patients were older (64.1 ± 0,7 vs 55.4 ± 0,9 years in asthma patients; p < 0,01), more often were males (98.7% vs 1.3%, p < 0.001) and smokers. Coronary heart disease (39.0% vs 25.3%; p < 0.010) and chronic heart failure (35.7% vs 17.5%; p < 0.001) were more common in patients with COPD, while rhinitis (42.4 % vs 3.9%; p < 0.001) and chronic kidney disease (13.1% vs 4.5%; p < 0.001) were more common in asthma patients. Allergic disease was 5-fold more often in asthma patients. Morning symptoms affected daily activity in 77.3% of COPD patients compared to 66.8% of asthma patients (p < 0.05). Generally, daytime activity was impaired in 55.2% of patients with COPD and in 12.7% of patients with asthma (p < 0.05). Excessive use of short-acting bronchodilators was noted at nighttime in 89.6% with COPD and 70.7% with asthma (p < 0.001). Other treatment was in line with guidelines for each the disease. The most convenient inhalational drug delivery device for COPD patients was a metered dosed inhaler, while patients with asthma preferred dry powder inhalers. Compliance of asthma patients was significantly higher than that of COPD patients (57.2% vs 27.8%; p < 0.001). The level of compliance did not change while fixed and free combinations of ICS and LABA or different inhalational devices were used in patients with COPD or asthma. Conclusion. There is a number of clinical signs to distinguish COPD and asthma quite easily in primary care facilities. Excessive use of short-acting bronchodilators and a low compliance of patients are issues requiring to be improved.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

Clinical and functional peculiarities at patients with bronchial asthma, chronic obstructive pulmonary disease and overlap of asthma-chronic obstructive pulmonary disease

2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Bronchial Asthma ◽  
Blood Test ◽  
Chronic Obstructive ◽  
Inflammation Markers ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Functional Features ◽  
Lower Airways

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.

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