Cargando…
A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial
BACKGROUND: Many patients with chronic obstructive pulmonary disease (COPD) suffer from exacerbations, a worsening of their respiratory symptoms that warrants medical treatment. Exacerbations are often poorly recognized or managed by patients, leading to increased disease burden and health care cost...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811767/ https://www.ncbi.nlm.nih.gov/pubmed/31599729 http://dx.doi.org/10.2196/14408 |
_version_ | 1783462532146528256 |
---|---|
author | Boer, Lonneke Bischoff, Erik van der Heijden, Maarten Lucas, Peter Akkermans, Reinier Vercoulen, Jan Heijdra, Yvonne Assendelft, Willem Schermer, Tjard |
author_facet | Boer, Lonneke Bischoff, Erik van der Heijden, Maarten Lucas, Peter Akkermans, Reinier Vercoulen, Jan Heijdra, Yvonne Assendelft, Willem Schermer, Tjard |
author_sort | Boer, Lonneke |
collection | PubMed |
description | BACKGROUND: Many patients with chronic obstructive pulmonary disease (COPD) suffer from exacerbations, a worsening of their respiratory symptoms that warrants medical treatment. Exacerbations are often poorly recognized or managed by patients, leading to increased disease burden and health care costs. OBJECTIVE: This study aimed to examine the effects of a smart mobile health (mHealth) tool that supports COPD patients in the self-management of exacerbations by providing predictions of early exacerbation onset and timely treatment advice without the interference of health care professionals. METHODS: In a multicenter, 2-arm randomized controlled trial with 12-months follow-up, patients with COPD used the smart mHealth tool (intervention group) or a paper action plan (control group) when they experienced worsening of respiratory symptoms. For our primary outcome exacerbation-free time, expressed as weeks without exacerbation, we used an automated telephone questionnaire system to measure weekly respiratory symptoms and treatment actions. Secondary outcomes were health status, self-efficacy, self-management behavior, health care utilization, and usability. For our analyses, we used negative binomial regression, multilevel logistic regression, and generalized estimating equation regression models. RESULTS: Of the 87 patients with COPD recruited from primary and secondary care centers, 43 were randomized to the intervention group. We found no statistically significant differences between the intervention group and the control group in exacerbation-free weeks (mean 30.6, SD 13.3 vs mean 28.0, SD 14.8 weeks, respectively; rate ratio 1.21; 95% CI 0.77-1.91) or in health status, self-efficacy, self-management behavior, and health care utilization. Patients using the mHealth tool valued it as a more supportive tool than patients using the paper action plan. Patients considered the usability of the mHealth tool as good. CONCLUSIONS: This study did not show beneficial effects of a smart mHealth tool on exacerbation-free time, health status, self-efficacy, self-management behavior, and health care utilization in patients with COPD compared with the use of a paper action plan. Participants were positive about the supportive function and the usability of the mHealth tool. mHealth may be a valuable alternative for COPD patients who prefer a digital tool instead of a paper action plan. TRIAL REGISTRATION: ClinicalTrials.gov NCT02553096; https://clinicaltrials.gov/ct2/show/NCT02553096. |
format | Online Article Text |
id | pubmed-6811767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-68117672019-11-14 A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial Boer, Lonneke Bischoff, Erik van der Heijden, Maarten Lucas, Peter Akkermans, Reinier Vercoulen, Jan Heijdra, Yvonne Assendelft, Willem Schermer, Tjard JMIR Mhealth Uhealth Original Paper BACKGROUND: Many patients with chronic obstructive pulmonary disease (COPD) suffer from exacerbations, a worsening of their respiratory symptoms that warrants medical treatment. Exacerbations are often poorly recognized or managed by patients, leading to increased disease burden and health care costs. OBJECTIVE: This study aimed to examine the effects of a smart mobile health (mHealth) tool that supports COPD patients in the self-management of exacerbations by providing predictions of early exacerbation onset and timely treatment advice without the interference of health care professionals. METHODS: In a multicenter, 2-arm randomized controlled trial with 12-months follow-up, patients with COPD used the smart mHealth tool (intervention group) or a paper action plan (control group) when they experienced worsening of respiratory symptoms. For our primary outcome exacerbation-free time, expressed as weeks without exacerbation, we used an automated telephone questionnaire system to measure weekly respiratory symptoms and treatment actions. Secondary outcomes were health status, self-efficacy, self-management behavior, health care utilization, and usability. For our analyses, we used negative binomial regression, multilevel logistic regression, and generalized estimating equation regression models. RESULTS: Of the 87 patients with COPD recruited from primary and secondary care centers, 43 were randomized to the intervention group. We found no statistically significant differences between the intervention group and the control group in exacerbation-free weeks (mean 30.6, SD 13.3 vs mean 28.0, SD 14.8 weeks, respectively; rate ratio 1.21; 95% CI 0.77-1.91) or in health status, self-efficacy, self-management behavior, and health care utilization. Patients using the mHealth tool valued it as a more supportive tool than patients using the paper action plan. Patients considered the usability of the mHealth tool as good. CONCLUSIONS: This study did not show beneficial effects of a smart mHealth tool on exacerbation-free time, health status, self-efficacy, self-management behavior, and health care utilization in patients with COPD compared with the use of a paper action plan. Participants were positive about the supportive function and the usability of the mHealth tool. mHealth may be a valuable alternative for COPD patients who prefer a digital tool instead of a paper action plan. TRIAL REGISTRATION: ClinicalTrials.gov NCT02553096; https://clinicaltrials.gov/ct2/show/NCT02553096. JMIR Publications 2019-10-09 /pmc/articles/PMC6811767/ /pubmed/31599729 http://dx.doi.org/10.2196/14408 Text en ©Lonneke Boer, Erik Bischoff, Maarten van der Heijden, Peter Lucas, Reinier Akkermans, Jan Vercoulen, Yvonne Heijdra, Willem Assendelft, Tjard Schermer. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 09.10.2019. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Boer, Lonneke Bischoff, Erik van der Heijden, Maarten Lucas, Peter Akkermans, Reinier Vercoulen, Jan Heijdra, Yvonne Assendelft, Willem Schermer, Tjard A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title | A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title_full | A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title_fullStr | A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title_full_unstemmed | A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title_short | A Smart Mobile Health Tool Versus a Paper Action Plan to Support Self-Management of Chronic Obstructive Pulmonary Disease Exacerbations: Randomized Controlled Trial |
title_sort | smart mobile health tool versus a paper action plan to support self-management of chronic obstructive pulmonary disease exacerbations: randomized controlled trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811767/ https://www.ncbi.nlm.nih.gov/pubmed/31599729 http://dx.doi.org/10.2196/14408 |
work_keys_str_mv | AT boerlonneke asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT bischofferik asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT vanderheijdenmaarten asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT lucaspeter asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT akkermansreinier asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT vercoulenjan asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT heijdrayvonne asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT assendelftwillem asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT schermertjard asmartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT boerlonneke smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT bischofferik smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT vanderheijdenmaarten smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT lucaspeter smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT akkermansreinier smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT vercoulenjan smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT heijdrayvonne smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT assendelftwillem smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial AT schermertjard smartmobilehealthtoolversusapaperactionplantosupportselfmanagementofchronicobstructivepulmonarydiseaseexacerbationsrandomizedcontrolledtrial |