An mHealth Management Platform for Patients with Chronic Obstructive Pulmonary Disease (efil breath): Randomized Controlled Trial

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Abstract

Background

Chronic obstructive pulmonary disease (COPD) is one of the major morbidities in public health, and the use of mHealth technology for rehabilitation of patients with COPD can help increase physical activity and ameliorate respiratory symptoms.

Objective

This study aimed to develop a comprehensive rehabilitation management platform to improve physical activity and quality of life in patients with COPD.

Methods

The study comprised the following 2 stages: (1) a pilot stage in which a prototype app was developed; and (2) a fully-fledged platform development stage in which 2 apps and 1 COPD patient monitoring website were developed. We conducted a randomized clinical trial to investigate the efficacy of the apps developed in the second stage of the study. In addition, two 12-week exercise regimens (fixed and fixed-interactive) were tested for the trial. The clinical parameters of the respiratory function and patient global assessment (PGA) of the app were obtained and analyzed. Notably, Android was the chosen operating system for apps.

Results

We developed 2 COPD rehabilitation apps and 1 patient monitoring website. For the clinical trial, 85 patients were randomized into the following 3 groups: 57 were allocated to the 2 intervention groups and 28 to the control group. After 6 weeks, the COPD assessment test scores were significantly reduced in the fixed group ( P=.01), and signs of improvement were witnessed in the fixed-interactive group. In addition, the PGA score was moderate or high in all aspects of the user experience of the apps in both intervention groups.

Conclusions

A well-designed mobile rehabilitation app for monitoring and managing patients with COPD can supplement or replace traditional center-based rehabilitation programs and achieve improved patient health outcomes.

Trial Registration

ClinicalTrials.gov NCT03432117; https://clinicaltrials.gov/ct2/show/NCT03432117 (Archived by WebCite at http://www.webcitation.org/71Yp0P64a)

Related collections

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Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.

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Is Open Access

Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

Huong Q. Nguyen, Dawn P Gill, Seth Wolpin … (2009)

Objective To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation. Methods Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9) or MOBILE-Self-Monitored (n = 8). All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instructed to continue to log their daily exercise and symptoms. MOBILE-Coached also received weekly reinforcement text messages on their cell phones; reports of worsening symptoms were automatically flagged for follow-up. Usability and satisfaction were assessed. Participants completed incremental cycle and six minute walk (6MW) tests, wore an activity monitor for 14 days, and reported their health-related quality of life (HRQL) at baseline, three, and six months. Results The sample had a mean age of 68 ±11 and forced expiratory volume in one second 18% predicted. Participants reported that logging their exercise and symptoms (FEV1) of 40 ± was easy and that keeping track of their exercise helped them remain active. There were no differences between groups over time in maximal workload, 6MW distance, or HRQL (p > 0.05); however, MOBILE-Self-Monitored increased total steps/day whereas MOBILE-Coached logged fewer steps over six months (p =0.04). Conclusions We showed that it is feasible to deliver a cell phone-based exercise persistence intervention to patients with COPD post-rehabilitation and that the addition of coaching appeared to be no better than self-monitoring. The latter finding needs to be interpreted with caution since this was a purely exploratory study. Trial registration ClinicalTrials.gov (NCT00373932).

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Author and article information

Contributors

Kichul Shin:

Department of Internal MedicineSeoul Metropolitan Government-Seoul National University Boramae Medical Center20 boramae Ro 5-gil Dongjak-guSeoul,Republic Of Korea82 2 870 320482 2 870 3866kideb1@gmail.com

ORCID: http://orcid.org/0000-0002-6749-7598

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: August 2018

Publication date (Electronic): 24 August 2018

Volume: 6

Issue: 8

Electronic Location Identifier: e10502

Affiliations

[1] ¹ LifeSemantics Corp Seoul Republic Of Korea

[2] ² Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul Republic Of Korea

[3] ³ Department of Internal Medicine Seoul Metropolitan Government-Seoul National University Boramae Medical Center Seoul Republic Of Korea

[4] ⁴ Division of Pulmonology Hanyang University College of Medicine Gyeonggi-do Republic Of Korea

[5] ⁵ Department of Internal Medicine Kyung Hee University School of Medicine Seoul Republic Of Korea

[6] ⁶ Department of Internal Medicine Yonsei University Wonju College of Medicine Gangwon-do Republic Of Korea

Author notes

Corresponding Author: Kichul Shin kideb1@ 123456gmail.com

Author information

Hee Kwon http://orcid.org/0000-0001-9910-1888

Sungin Lee http://orcid.org/0000-0002-4260-2160

Eun Ji Jung http://orcid.org/0000-0002-9987-0529

SangHee Kim http://orcid.org/0000-0002-8496-6317

Jung-Kyu Lee http://orcid.org/0000-0001-5060-7255

Deog Kyeom Kim http://orcid.org/0000-0001-9379-8098

Tae-Hyung Kim http://orcid.org/0000-0002-3863-7854

Seung Hyeun Lee http://orcid.org/0000-0002-7666-313X

Myoung Kyu Lee http://orcid.org/0000-0002-2450-4882

Seungjae Song http://orcid.org/0000-0002-6963-9123

Kichul Shin http://orcid.org/0000-0002-6749-7598

Article

Publisher ID: v6i8e10502

DOI: 10.2196/10502

PMC ID: 6128957

PubMed ID: 30143475

SO-VID: ebd095b3-7282-48c7-a2b8-f772fd0b07cc

Copyright © ©Hee Kwon, Sungin Lee, Eun Ji Jung, SangHee Kim, Jung-Kyu Lee, Deog Kyeom Kim, Tae-Hyung Kim, Seung Hyeun Lee, Myoung Kyu Lee, Seungjae Song, Kichul Shin. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.08.2018.

License:

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.

History

Date received : 26 March 2018

Date revision requested : 22 April 2018

Date revision received : 17 June 2018

Date accepted : 26 July 2018

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