Remote daily real-time monitoring in patients with COPD – A feasibility study using a novel device

Abstract

New technologies have allowed remote real-time electronic recording of symptoms and spirometry. The feasibility of utilising this technology in COPD patients has not been investigated. This is a feasibility study. The primary objective is to determine whether the use of an electronic diary with a portable spirometer can be performed by COPD patients with a moderate to severe disease. Secondary objectives are to investigate the value of this method in early detection of acute exacerbations of COPD (AECOPD). In this 6-month study, 18 patients recorded daily their symptom score and spirometry. Data was sent on real time. AECOPD which was defined according to pre-set criteria were noted. Spirometry values and scores for health-related quality of life were compared between the start and the end of the study. Hospitalisation rate due to AECOPD was compared with a parallel period in the previous year. On average, patients were able to record 77% of their total study days. The system detected 73% of AECOPD. In further 27% of AECOPD patients sought treatment although the change in symptoms did not meet AECOPD definition. The number of COPD-related hospitalisations significantly reduced compared to the previous year. There was a significant increase in FEV(1) and FVC from the start to the end of the study. The remote monitoring device used in this study can be used in COPD patients. AECOPD was detected early in the majority of cases. Hospitalisation rate due to AECOPD was reduced and FEV(1) and FVC values increased during the study.

Feasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study (Preprint)

“…The availability of symptoms surveys that our patients provided was similar to the literature (70% in our study vs 77% in a similar study). [21] This may support the approach for data collection through passive sensors as it may be problematic to reliably obtain symptom surveys from patients with COPD on a long term basis. [14] We found gender differences in our study as more men were recruited and more men completed the study.…”

Monitoring of Physiological Parameters to Predict Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review

“…Of the 16 articles included in this review, only eight studies (three at high risk of bias, one at low quality and two at moderate quality) [5,13,14,18,19,20,21,25] mentioned that they had customised the alarm limits for each individual. Methods used were reported in six out of the eight studies.…”

“…A few studies assessed the usefulness of lung function variables in predicting acute exacerbation. Eight studies (two at high risk of bias, one as low quality, and two at moderate quality) of 16 [5,7,12,13,14,16,21,23] monitored either the peak expiratory flow rate (PEFR), or the forced expiratory volume in one second (FEV 1 ), or both. Three studies [12,13,23] measured FEV 1 and PEFR at different frequencies (per day/per week).…”

“…Sund et al at low quality and Mohktar et al at moderate quality [14,21] focused only on FEV 1 . Sund [14] detected 55/75 exacerbations using monitoring, and 6/55 exacerbations were detected only via FEV 1 (defined as a 10% fall in FEV 1 for ≥2 consecutive days).…”

“…Sund [14] detected 55/75 exacerbations using monitoring, and 6/55 exacerbations were detected only via FEV 1 (defined as a 10% fall in FEV 1 for ≥2 consecutive days). Three studies [5,7,16] examined predicting COPD exacerbations with daily monitoring of PEFR.…”