Digital Therapeutics Research, Case Studies and Evaluations.
A randomised controlled feasibility trial of E-health application supported care vs usual care after exacerbation of COPD
First publication of complete results shows the myCOPD app could play an important role in supporting recovery following an exacerbation of COPD.
The results from the RESCUE trial (MMH-R02), investigating the possible impact of myCOPD in supporting the recovery of patients admitted with an exacerbation of COPD were published in NPJ Digital Medicine Journal.
Exacerbations of COPD are one of the commonest causes of admission and re-admission to hospital. The role of digital interventions to support self-management in improving outcomes is uncertain.
We conducted an open, randomised controlled trial of myCOPD in 41 COPD patients recruited following hospital admission with an acute exacerbation. Subjects were randomised to either receive usual care, including a written self-management plan (n=21), or the myCOPD app (n=20) for 90 days.
The primary efficacy outcome was recovery rate of symptoms measured by COPD Assessment Test (CAT) score. Exacerbations, readmission, inhaler technique quality of life and patient activation (PAM) scores were also captured.
Results showed the app was acceptable in this care setting and was used by 17 of the 21 patients with sustained use over the study period. The treatment effect on CAT score was 4.49 (95% CI: -8.41, -0.58) points lower in the myCOPD arm.
Patients’ inhaler technique improved in the digital intervention arm (101 improving to 20 critical errors) compared to usual care (100 to 72 errors).
Exacerbations tended to be less frequent in the digital arm compared to usual care; 34 vs 18 events. Hospital re-admissions risk was 30 numerically lower in the digital intervention arm: OR for readmission 0.383 (95%CI 0.074, 1.987; 31 n=35).
In this feasibility study of the digital self-management platform myCOPD, the app has proven acceptable. Its use has improved exacerbation recovery rates, with strong signals of lower re-exacerbation and re-admission rates over 90 days. myCOPD reduced the number of critical errors in inhaler technique compared to usual care with written self-management. This provides a strong basis for further exploration of the use of app interventions in the context of recently hospitalised patients with COPD.Read the full paper on npj Digital Medicine