Background Pulmonary rehabilitation is one of the main interventions to reduce the use of health resources, and it promotes a reduction in chronic obstructive pulmonary disease (COPD) costs. mHealth systems in COPD aim to improve adherence to maintenance programs after pulmonary rehabilitation by promoting the change in attitude and behavior necessary for patient involvement in the management of the disease. Objective This study aimed to assess the effects of an integrated care plan based on an mHealth web-based platform (HappyAir) on adherence to a 1-year maintenance program applied after pulmonary rehabilitation in COPD patients. Methods COPD patients from three hospitals were randomized to a control group or an intervention group (HappyAir group). Patients from both groups received an 8-week program of pulmonary rehabilitation and educational sessions about their illness. After completion of the process, only the HappyAir group completed an integrated care plan for 10 months, supervised by an mHealth system and therapeutic educator. The control group only underwent the scheduled check-ups. Adherence to the program was rated using a respiratory physiotherapy adherence self-report (CAP FISIO) questionnaire. Other variables analyzed were adherence to physical activity (Morisky-Green Test), quality of life (Chronic Obstructive Pulmonary Disease Assessment Test, St. George’s Respiratory Questionnaire, and EuroQOL-5D), exercise capacity (6-Minute Walk Test), and lung function. Results In total, 44 patients were recruited and randomized in the control group (n=24) and HappyAir group (n=20). Eight patients dropped out for various reasons. The CAP FISIO questionnaire results showed an improvement in adherence during follow-up period for the HappyAir group, which was statistically different compared with the control group at 12 months (56.1 [SD 4.0] vs 44.0 [SD 13.6]; P=.004) after pulmonary rehabilitation. Conclusions mHealth systems designed for COPD patients improve adherence to maintenance programs as long as they are accompanied by disease awareness and patient involvement in management. Trial Registration ClinicalTrials.gov NCT04479930; https://clinicaltrials.gov/ct2/show/NCT04479930
BACKGROUND Pulmonary rehabilitation is the most successful intervention to reduce the use of health resources and it promotes a reduction in COPD costs. m-Health systems in COPD aim to improve adherence to maintenance programs after PR by promoting the change in attitude and behaviour necessary for patient involvement in the management of the disease. OBJECTIVE This study aimed to assess the effectivity to promote adherence of an m-health system designed specifically for COPD patients and their needs. METHODS COPD patients from three different hospitals were randomized to a control group (CG) or an intervention group (Happyair group: HG). They developed an 8-week program of rehabilitation and educational sessions about their illness. After completion of the process, only HG performed a comprehensive maintenance program for 10 months, supervised by an m-health system and therapeutic educator. The control group only underwent the scheduled check-ups. Adherence to the program was rated using CAP FISIO questionnaire. Other variables as adherence to physical activity, quality of life or exercise capacity were analysed by Morisky-Green questionnaire, CAT questionnaire and 6MWT, respectively. RESULTS In total, 44 patients were recruited and randomized in CG(n=20) and HG(n=24). 8 patients dropped out for different reasons. CAP FISIO questionnaire results showed an improvement in adherence during follow up period, for HG, observed at 6 and 12 months after pulmonary rehabilitation: 6 months (53.6±5.4; P<0.05) and 12 months (56.1±4; P<0.04) CONCLUSIONS m-health systems designed for COPD patients improve adherence to maintenance programs, as long as they are accompanied by disease awareness and patient involvement in management.
BackgroundEstimating current and future impact of chronic obstructive pulmonary disease (COPD) within the European Union (EU) is essential for targeted and well-informed policy-making, however, current global and regional estimates are contradictory, and comparable standardised data is lacking. Without it the burden felt by individuals and healthcare systems cannot be fully quantified and a collective and coordinated response cannot be achieved to protect economies and communities from further harm.AimOur purpose was toCollect data to enable a comparative assessment of the COPD burden across EU 28 member states and highlight variation.Show the impact of COPD in the workplace, on healthcare utilisation and on quality of life of the EU population.Use the data to underpin a simulation model to demonstrate future impact on societies, health inequalities and healthcare utilisation depending on which interventions are selected.MethodsA systematic literature review was performed to identify regional and national data on COPD prevalence, risk factors (e.g. smoking, air pollution), impact and costs across the EU. Workshops with stakeholders from a range of European countries were convened to test the face validity of the data, and to develop policy-level questions from which a simulation model could be developed.ResultsPrevalence estimates of COPD varied considerably (1.26% to 13.87%), partly because of different definitions. As smoking rates are less affected by definition differences, these were used in a model that predicts COPD incidence, prevalence and mortality. Correction factors were applied to account for non-smoking related causes and under diagnosis of smoking. Smoking prevalence rates were used to estimate data for equivalent countries for the countries where smoking data were not available. The simulation model is currently in development and first results are expected in Autumn 2016.ConclusionThe European COPD Coalition (ECC) will use the results to facilitate dialogue with EU decision makers (European Commission Council and Parliament) on health policy, outlining the problem and providing evidence to support the call for political actions on COPD. It will also be of significant interest to healthcare professionals, patients, and respiratory organisations with a passion to improve COPD care
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