Digital Health App Detects COPD Earlier, Treats Patients Earlier

Health application allows patients to report respiratory symptoms and peak flow measurements from COPD.

Health application allows patients to report respiratory symptoms and peak flow measurements from COPD.

A digital health application was able to detect chronic obstructive pulmonary disease (COPD) earlier to treat exacerbation symptoms in patients who participated in an analysis at the Temple Lung Center.

COPD is the third leading cause of death in the United States. The condition involves restricted airflow from inflammation and flare-ups called exacerbations, in which patients may experience increased coughing, mucus, shortness of breath, wheezing, and a feeling of tightness in their chest.

Leaving these symptoms untreated can escalate the situation and lead to repeated trips to the emergency room, disability, and diminished quality of life.

Scientists at the Temple Lung Center conducted a 320-day assessment of patient compliance with daily COPD symptom reporting using a digital health application as part of a continuous quality improvement program.

“Given a general lack of awareness among patients of small day-to-day symptom changes and the pace of symptom worsening in COPD, daily COPD telemonitoring is an attractive approach to facilitate early intervention, provided that the system is used and that the health care provider responds in a timely manner,” said Gerard J. Criner, MD, FACP, FACCP, founding chair of the Department of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University, and director of Temple Lung Center.

“Patient adherence to daily symptom reporting system using this application exceeded 90% for more than half of the participants, and 90% of worsening COPD symptom reports were responded to in less than 11 hours with patient-specific treatment recommendations. That’s substantially better than response times reported in recent COPD research literature.”

The health application allows patients to report their respiratory symptoms and peak flow measurements. These symptoms are then converted into measurable data called a symptom score by a computer algorithm.

The score is then compared with a patient’s baseline metrics. Scores that go beyond the baseline metrics by a predetermined amount generate an alert that is transferred to the patient and stored in the system for a nurse to review.

Based on the symptoms reported, the nurse will suggest a treatment recommendation and forward it to a pulmonologist for approval. Once it is approved by the pulmonologist, the nurse transmits the recommendation to the patient via text or email.

This research follows another Temple-led study published on August 10, 2015, which found that patients who used the digital application to report their daily symptoms and received same-day treatment recommendations experienced fewer and less severe COPD exacerbation symptoms.

This led to a significant improvement in daily symptom control, lung functionality, and activity status.

“Early interventions for worsening COPD symptoms shortens their duration and reduces their severity,” said lead author Michael R. Jacobs, PharmD, professor of Clinical Pharmacy at Temple University School of Pharmacy and director of Clinical Research for the Department of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine. “This digital health application is an example of how emerging technology can help facilitate early intervention and treatment by the health care team.”

Limitations to the study include the small number of patients and the fact that all patients involved were quite ill, indicating a stronger need and motivation for daily symptom reporting than if they were less ill. Additionally, the lack of a control group and limited follow-up duration left the team unable to comment on whether health care utilization was impacted.