Digital Therapeutics Research, Case Studies and Evaluations.
A real-world service evaluation of myCOPD
Results of a supported self-management evaluation of COPD patients by Stonehaven Medical Group and Aberdeenshire Health & Social Care Partnership (NHS Grampian).
Kris McLaughlin, Erika Skinner
Stonehaven Medical Group and Aberdeenshire Health & Social Care Partnership designed this test of change evaluation to explore the impact of myCOPD on patient self-management, exacerbations frequency, unscheduled general practice (GP) consultations and hospital admissions.
Chronic Obstructive Pulmonary Disease (COPD) is a common and serious disease of the lungs. Many people in the UK suffer with the disease and it is a leading cause of hospital admissions. Preventing COPD exacerbations and promoting overall wellbeing can be achieved through supportive self-management of disease. However, successful self-management is dependent on the knowledge and skills provided to patients to give them the confidence to make the right decisions about their treatments, use of healthcare services and lifestyle choices. Digital tools can be a useful resource to support patient self-management. The NICE accredited myCOPD app provides structured education, pulmonary rehabilitation, inhaler videos to promote good inhaler technique as well as supportive self-management tools.
This test of change evaluation was conducted in primary care in 2019. At 5 months data was collected to review any outcomes since myCOPD was introduced. Overall, 64 patients agreed to take part with 43 agreeing to an early review. Of these 43, 23 (53.4%) patients who had been given access to myCOPD attended the interim review.
The evaluation involved measuring CAT score, inhaler technique including rescue inhaler usage, healthcare usage and hospital admissions, and patient feedback.
Results identified 4 key outcomes:
- An overall improvement in mean CAT score of -2.1 since the start of the study
- A mean reduction in rescue inhaler use was observed from 3.17 to 2.13, demonstrating an improvement in symptom control. There was also an overall improvement in inhaler technique, where good inhaler technique practices increased from 48 to 91%
- There was a reduction observed in healthcare usage when comparing patient data prior to myCOPD. Overall, there were 20 (19%) less unscheduled GP appointments (reduction range of 105 to 85), and hospital admissions dropped from 6 to 0 during this time
- Patient feedback showed that the proportion of patients who described their ability to manage exacerbations very well rose from 29 to 55%, and those who felt confident using an inhaler rose from 76 to 90%
This real-world evaluation of myCOPD provides valuable insights into the benefits of using digital health to support self-management. Recent studies have shown that myCOPD can provide patients with an alternative, or adjunct, to their COPD healthcare management. These results reinforce the evidence base from our formal RCTs (EARLY and RESCUE) which showed that using myCOPD improved inhaler technique, reduced CAT score, exacerbations and hospital admissions.
Based on these results, Stonehaven Medical Group, NHS Grampian’s Respiratory Managed Clinical Network canvassed for widespread adoption of myCOPD. This is to be commissioned by the Operation Home First Steering Group who have approved funding to enable rapid deployment of myCOPD during winter 2020/21.
Research TopicsCOPD Digital Therapeutics Self-management CAT score Rescue inhaler NHS Grampian Digital Health MedTech