Development and Preliminary Evaluation of the Effects of an mHealth Web-Based Platform (HappyAir) on Adherence to a Maintenance Program After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial (Preprint)

Abstract

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.

Pulmonary Rehabilitation: Time for an Upgrade

“…Among the potential ways to extend the benefits of PR the use of telemedicine and medical technology has gained quite popularity. In a recent study published by Jimenez et al [ 11 ], the addition of a mHealth application with a patient-educator interaction following a pulmonary rehabilitation programme of 12 weeks resulted in an increase in adherence to respiratory physiotherapy treatment compared to a control group. Technology-supported exercise interventions, with the addition of a monitoring device, such as a pedometer or a fitness tracker, have shown to be effective in improving physical activity when a target is set (for example, 10.000 steps per day) [ 12 ].…”