Recruiting patients to a digital self-management study whilst in hospital for a chronic obstructive pulmonary disease exacerbation: A feasibility analysis

Maxine Whelan, Christopher Biggs, Carlos Areia, Elizabeth King, Bethany Lawson, Nikki Newhouse, Xiaorong Ding, Carmelo Velardo, Mona Bafadhel, Lionel Tarassenko, Peter Watkinson, David Clifton, Andrew Farmer

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    1 Citation (Scopus)
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    Abstract

    Background
    Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised with acute exacerbations (AECOPD) and many patients get readmitted. Intervening with hospitalised patients may be optimal timing to provide support. Our previous work demonstrated use of a digital monitoring and self-management support tool in the community. However, we wanted to explore the feasibility of recruiting patients whilst hospitalised for an AECOPD, and to identify the rate of dropout attrition around admission for AECOPD.
    Methods
    Patients were recruited to the EDGE2 study between May 2019 and March 2020. Patients were identified by the clinical teams and patients were recruited by members of the clinical research team. Participants were aged 40 years or older, had a diagnosis of COPD and were attending or admitted to hospital for an AECOPD. Participants were given a tablet computer, Bluetooth-linked pulse oximeter and wrist-worn physical activity monitor to use until 6 months post-discharge. Use of the system aimed to support COPD self-management by enabling self-monitoring of vital signs, COPD symptoms, mood and physical activity, and access to multi-media educational resources.
    Results
    281 patients were identified and 126 approached. The main referral source was the specialist respiratory nursing and physiotherapist team (49.8% of patients identified). Twenty-six (37.1%) patients were recruited. As of 21 April 2020, 14 (53.8%) participants withdrew and 11 (of 14; 78.6%) participants withdrew within four weeks of discharge. The remaining participants withdrew between one and three months follow-up (1 of 14; 7.1%) and between three and six months follow-up (2 of 14; 14.3%).
    Conclusion
    A large number of patients were screened to recruit a relatively small sample and a high rate of dropout was observed. It does not appear feasible to recruit patients with COPD to digital interventional studies from the hospital setting when they have the burden of coping with acute illness.
    Original languageEnglish
    Number of pages5
    JournalDigital Health
    Volume7
    Early online date27 May 2021
    DOIs
    Publication statusPublished - 10 Jun 2021

    Bibliographical note

    Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

    Funder

    The EDGE2 project was funded by the NIHR Oxford Biomedical Research Centre and the Engineering and Physical Sciences Research Council.

    Keywords

    • COPD
    • Feasibility
    • hospital admission
    • respiratory
    • self monitoring
    • wearables

    ASJC Scopus subject areas

    • Health Policy
    • Health Informatics
    • Computer Science Applications
    • Health Information Management

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