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Digital health system for personalised COPD long-term management
BACKGROUND: Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for s...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319140/ https://www.ncbi.nlm.nih.gov/pubmed/28219430 http://dx.doi.org/10.1186/s12911-017-0414-8 |
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author | Velardo, Carmelo Shah, Syed Ahmar Gibson, Oliver Clifford, Gari Heneghan, Carl Rutter, Heather Farmer, Andrew Tarassenko, Lionel |
author_facet | Velardo, Carmelo Shah, Syed Ahmar Gibson, Oliver Clifford, Gari Heneghan, Carl Rutter, Heather Farmer, Andrew Tarassenko, Lionel |
author_sort | Velardo, Carmelo |
collection | PubMed |
description | BACKGROUND: Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for successful disease management. A patient-centred design approach is needed in order to allow the personalisation of interventions and encourage the completion of daily self-management tasks. METHODS: A digital health system was designed to support patients suffering from chronic obstructive pulmonary disease in self-managing their condition. The system includes a mobile application running on a consumer tablet personal computer and a secure backend server accessible to the health professionals in charge of patient management. The patient daily routine included the completion of an adaptive, electronic symptom diary on the tablet, and the measurement of oxygen saturation via a wireless pulse oximeter. RESULTS: The design of the system was based on a patient-centred design approach, informed by patient workshops. One hundred and ten patients in the intervention arm of a randomised controlled trial were subsequently given the tablet computer and pulse oximeter for a 12-month period. Patients were encouraged, but not mandated, to use the digital health system daily. The average used was 6.0 times a week by all those who participated in the full trial. Three months after enrolment, patients were able to complete their symptom diary and oxygen saturation measurement in less than 1 m 40s (96% of symptom diaries). Custom algorithms, based on the self-monitoring data collected during the first 50 days of use, were developed to personalise alert thresholds. CONCLUSIONS: Strategies and tools aimed at refining a digital health intervention require iterative use to enable convergence on an optimal, usable design. ‘Continuous improvement’ allowed feedback from users to have an immediate impact on the design of the system (e.g., collection of quality data), resulting in high compliance with self-monitoring over a prolonged period of time (12-month). Health professionals were prompted by prioritisation algorithms to review patient data, which led to their regular use of the remote monitoring website throughout the trial. TRIAL REGISTRATION: Trial registration: ISRCTN40367841. Registered 17/10/2012. |
format | Online Article Text |
id | pubmed-5319140 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53191402017-02-24 Digital health system for personalised COPD long-term management Velardo, Carmelo Shah, Syed Ahmar Gibson, Oliver Clifford, Gari Heneghan, Carl Rutter, Heather Farmer, Andrew Tarassenko, Lionel BMC Med Inform Decis Mak Research Article BACKGROUND: Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for successful disease management. A patient-centred design approach is needed in order to allow the personalisation of interventions and encourage the completion of daily self-management tasks. METHODS: A digital health system was designed to support patients suffering from chronic obstructive pulmonary disease in self-managing their condition. The system includes a mobile application running on a consumer tablet personal computer and a secure backend server accessible to the health professionals in charge of patient management. The patient daily routine included the completion of an adaptive, electronic symptom diary on the tablet, and the measurement of oxygen saturation via a wireless pulse oximeter. RESULTS: The design of the system was based on a patient-centred design approach, informed by patient workshops. One hundred and ten patients in the intervention arm of a randomised controlled trial were subsequently given the tablet computer and pulse oximeter for a 12-month period. Patients were encouraged, but not mandated, to use the digital health system daily. The average used was 6.0 times a week by all those who participated in the full trial. Three months after enrolment, patients were able to complete their symptom diary and oxygen saturation measurement in less than 1 m 40s (96% of symptom diaries). Custom algorithms, based on the self-monitoring data collected during the first 50 days of use, were developed to personalise alert thresholds. CONCLUSIONS: Strategies and tools aimed at refining a digital health intervention require iterative use to enable convergence on an optimal, usable design. ‘Continuous improvement’ allowed feedback from users to have an immediate impact on the design of the system (e.g., collection of quality data), resulting in high compliance with self-monitoring over a prolonged period of time (12-month). Health professionals were prompted by prioritisation algorithms to review patient data, which led to their regular use of the remote monitoring website throughout the trial. TRIAL REGISTRATION: Trial registration: ISRCTN40367841. Registered 17/10/2012. BioMed Central 2017-02-20 /pmc/articles/PMC5319140/ /pubmed/28219430 http://dx.doi.org/10.1186/s12911-017-0414-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Velardo, Carmelo Shah, Syed Ahmar Gibson, Oliver Clifford, Gari Heneghan, Carl Rutter, Heather Farmer, Andrew Tarassenko, Lionel Digital health system for personalised COPD long-term management |
title | Digital health system for personalised COPD long-term management |
title_full | Digital health system for personalised COPD long-term management |
title_fullStr | Digital health system for personalised COPD long-term management |
title_full_unstemmed | Digital health system for personalised COPD long-term management |
title_short | Digital health system for personalised COPD long-term management |
title_sort | digital health system for personalised copd long-term management |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319140/ https://www.ncbi.nlm.nih.gov/pubmed/28219430 http://dx.doi.org/10.1186/s12911-017-0414-8 |
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