Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is highly prevalent and is associated with a heavy burden on patients and health systems alike. Exacerbations of COPD (ECOPDs) are a leading cause of acute hospitalization among all adult chronic diseases. There is currently a paradigm shift in the way that ECOPDs are conceptualized. For the first time, objective physiological parameters are being used to define/classify what an ECOPD is (including heart rate, respiratory rate, and oxygen saturation criteria) and therefore a mechanism to monitor and measure their changes, particularly in an outpatient ambulatory setting, are now of great value. In addition to pre-existing challenges on traditional ‘in-person’ health models such as geography and seasonal (ex. winter) impacts on the ability to deliver in-person visit-based care, the COVID-19 pandemic imposed additional stressors including lockdowns, social distancing, and the closure of pulmonary function labs. These health system stressors, combined with the new conceptualization of ECOPDs, rapid advances in sophistication of hardware and software, and a general openness by stakeholders to embrace this technology, have all influenced the propulsion of remote patient monitoring (RPM) and wearable technology in the modern care of COPD. The present article reviews the use of RPM and wearable technology in COPD. Context on the influences, factors and forces which have helped shape this health system innovation is provided. A focused summary of the literature of RPM in COPD is presented. Finally, the practical and ethical principles which must guide the transition of RPM in COPD into real-world clinical use are reviewed.

Feasibility, functionality, and user experience with wearable technologies for acute exacerbation monitoring in patients with severe COPD

“…In conclusion, the current landscape of remote patient monitoring has been defined by rapid evolution and incredible innovations in technology as well as by sizeable and persisting challenges to clinical implementation and real-world application (Subramanian et al, 2004;Gottlieb et al, 2014;Iranpak et al, 2021;Coutu et al, 2023). The present study provides important foundational evidence for the autonomous operation of noninvasive, comfortable wearable devices including excellent adherence to device wear and effective ambulatory data collection in a near-continuous manner and remote transmission, for several weeks at a time, by older patients with severe forms of COPD experiencing a current exacerbation.…”

“…Potential technology illiteracy and discomfort with technology use (both software and hardware) is prevalent and may be even more common in older patients with COPD (Jiang et al, 2023), those with advanced chronic disease, and those with frequent exacerbations. Paradoxically, these same patients, who stand most likely to benefit from such innovations in management, are at risk of being excluded altogether in studies which investigate technological innovations to care (Western et al, 2021;Navathe et al, 2022;Coutu et al, 2023). The primary objective of this study was to determine the capacity of patients with severe COPD who are experiencing a current exacerbation to operate wearable technology and to autonomously collect and transmit physiological data as outpatients over several consecutive weeks.…”

Navigating the Future: The Transformative Impact of Artificial Intelligence on Hospital Management- A Comprehensive Review

“…This proactive approach to healthcare enhances patient outcomes by enabling early intervention and reduces the need for frequent hospital visits. Integrating AI in remote monitoring improves healthcare delivery efficiency and aligns with the growing emphasis on patient-centric care and the broader trend of shifting healthcare beyond traditional hospital settings [ 12 ].…”

Digital biomarkers: 3PM approach revolutionizing chronic disease management — EPMA 2024 position

“…Other wearables detect frequency and strength of breathing using audio of inhalations and expirations together with measurements of chest expansion and contraction. These DBs enable frequent and accurate monitoring of lung function, allowing for timely adjustments in treatment plans [ 56 , 57 ] Physical activity tracking COPD is often accompanied by reduced physical activity levels which can further exacerbate the condition. Wearable devices with accelerometers can measure parameters such as step count, distance traveled, and energy expenditure.…”