Abstract
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 language | English |
|---|---|
| Number of pages | 5 |
| Journal | Digital Health |
| Volume | 7 |
| Early online date | 27 May 2021 |
| DOIs | |
| Publication status | Published - 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.Funding
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MB reports outside the submitted work research grant reports from AZ; honoraria from AZ, Chiesi, and GlaxoSmithKline; and is on the scientific advisory board for AlbusHealth\u00AE and ProAxsis\u00AE. CV reports other from Sensyne Health, plc, outside the submitted work. LT reports grants from NIHR Biomedical Research Centre, Oxford, during the conduct of the study; personal fees from Sensyne Health, outside the submitted work. PW reports grants from NIHR Biomedical Research Centre Oxford, during the conduct of the study; grants from National Institute of Health Research (NIHR), grants from Wellcome Trust, other from Sensyne Health, outside the submitted work. Professor Andrew Farmer is a NIHR Senior Investigator. DC reports personal fees from Oxford University Innovation, personal fees from Biobeats, personal fees from Sensyne Health, outside the submitted work. All remaining authors declare no competing interests. We would like to thank the EDGE2 participants for taking part and for the various clinical teams for their involvement in identifying and screening patients. The EDGE2 project is also supported by a large multidisciplinary research team including other members of the clinical research team in the Kadoorie Centre, Nuffield Department of Clinical Neurosciences and the Oxford Primary Care Clinical Trials Unit as well as engineering colleagues in the Institute of Biomedical Engineering. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The EDGE2 project was funded by the NIHR Oxford Biomedical Research Centre and the Engineering and Physical Sciences Research Council. The funders played no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.
Keywords
- COPD
- Feasibility
- hospital admission
- respiratory
- self monitoring
- wearables
ASJC Scopus subject areas
- Health Policy
- Health Informatics
- Computer Science Applications
- Health Information Management
