RT Journal Article
SR Electronic
T1 Innovating the treatment of COPD exacerbations: a phone interactive telesystem to increase COPD Action Plan adherence
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e000379
DO 10.1136/bmjresp-2018-000379
VO 6
IS 1
A1 Raquel Farias
A1 Maria Sedeno
A1 Danielle Beaucage
A1 Isabelle Drouin
A1 Isabelle Ouellet
A1 Alexandre Joubert
A1 Rita Abimaroun
A1 Meena Patel
A1 Mira Abou Rjeili
A1 Jean Bourbeau
YR 2019
UL http://bmjopenrespres.bmj.com/content/6/1/e000379.abstract
AB Introduction Self-management interventions with Written Action Plans and case management support have been shown to improve outcomes in patients with chronic obstructive pulmonary disease (COPD). Novel telehealth technologies may improve self-management interventions. The objectives of this study were to determine whether the use of an interactive phone telesystem increases Action Plan adherence, improves exacerbation recovery and reduces healthcare use in a real-life practice of a COPD clinic.Methods Initially, 40 patients were followed by a COPD telesystem for 1 year. Detailed data from patients’ behaviours during exacerbations was recorded. The telesystem use was then extended to 256 patients from a real-life COPD clinic. Healthcare utilisation for the year before and after telesystem enrolment was then assessed through hospital administrative databases.Results Thirty-three of the 40 patients completed the initial 1-year study. Eighty-one exacerbations were reported in the 1-year follow-up. Action Plan adherence was observed for 72% of the exacerbations and those who were adherent had a significantly faster exacerbation recovery time. The large-scale implementation of the telesystem resulted in a significant decrease in the proportion of patients with ≥1 respiratory-related emergency room (ER) visits (120 before vs 110 after enrolment, p<0.001) and with ≥1 COPD-related hospitalisations (75 before vs 65 after enrolment, p<0.001).Discussion COPD Written Action Plan adherence was further enhanced with the use of telehealth technologies in a specialised clinic with experience in COPD self-management. Patients followed by the telesystem recovered faster from exacerbations and had a further decrease in COPD-related ER visits and hospitalisations.Trial registration number NCT02275078.