Aim The prevalence of chronic obstructive pulmonary disease (COPD) in poor, remote, and rural populations is twice that of cities (15.4% versus 8.4%).1 COPD costs the NHS an estimated £1.9bn/year2 and is characterised by exacerbation frequency and severity. Disease education and self-management are critical to reducing the healthcare burden for patients with COPD.
We evaluated myCOPD, a digital self-management technology in a predominantly remote and rural population. We assessed whether myCOPD was effective in reducing hospital admissions, inpatient bed days and other NHS service usage.
Method 120 people were recruited over 6 months. We compared data regarding hospital admissions, inpatient bed days, clinic attendances, out of hours contacts and home visits 12 months before and up to 12 months after myCOPD activation. To account for differences in activation rates and the early termination of the study due to COVID-19 data was reported as daily outcome measures.
Results The average participant age was 67, with a GOLD score 1–4 (average 2.7). The average 6-fold urban-rural score was 4.23 indicating a predominantly remote and/or rural population. 78% of patients activated myCOPD, 70% recorded their symptom score at least once, and 45% used >1 myCOPD module. There was no association between myCOPD use and participant demographics.
There were no statistically significant differences in hospital admissions, inpatient bed days, or other health service utilisation before and after myCOPD activation. However, a subgroup analysis found that those individuals with the greatest degree of myCOPD engagement either by frequency of symptom scoring (figure 1A) or by numbers of modules used (figure 1B) did show a reduction in bed days.
Conclusion These data indicate no association between myCOPD use and either reduced bed days or other NHS service use on a whole group level however it may be of benefit to individuals with higher levels of engagement. Overall these results have significant implications regarding the design and evaluation of novel service innovations in COPD and other chronic disorders.
Raju S, et al. Rural Residence and Poverty are independent risk factors for chronic obstructive pulmonary disease in the United States. AJRCCM 2019;199(8):961–969.
Trueman D, et al. Estimating the economic burden of respiratory illness in the UK. British Lung Foundation 2017. URL: https://www.blf.org.uk/policy/economic-burden
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