By Tom Stibolt, MD, Mobile Musings Column Editor

Temple University released an online article in the journal Telemedicine and e-Health in September, describing the use of an app to help patients with COPD manage their disease following a hospitalization.

The app was created for patients with COPD to help them recognize worsening symptoms that require more intense therapy. Recent research shows that some patients fail to identify symptoms, and some patients are reluctant to contact their health care provider when feeling minimal increases in symptoms. A telemedicine application for daily symptom reporting may reduce treatment barriers and improve patient outcomes.

The study included both an intervention and a control arm. Participants were recently hospitalized patients, as well as patients using supplemental oxygen. Patients initially received optimal COPD care and were given a telecommunication device for symptom reporting. Initial symptom scores were obtained while patients were in their usual state of health. Control group patients were instructed to seek medical care if their condition worsened. Intervention patients’ daily symptom scores were collected by the application, assessed by a computer algorithm, and compared to initial values. Scores 1 or more points above the initial score generated an “alert,” and patients were reviewed by a nurse and referred to a physician for treatment. Seventy-nine patients were initially enrolled, with 40 in the control group and 39 receiving intervention. Seven control and five intervention patients provided five or fewer symptom reports, and they were dropped from the analysis. Daily peak flow and dyspnea scores improved only in the intervention group. No differences in hospitalization and mortality rates were observed between groups, and no serious adverse events were reported. Investigators felt that the study was underpowered to detect significant changes in hospitalization or mortality.

Gerard Criner, MD, director of the Temple Lung Center and principal investigator of the study, notes that “previous studies at other sites have questioned the efficacy of various telemedicine solutions in COPD patients, but those studies have not used a solution that enables same-day treatment in response to worsening patient symptoms.” The investigators are planning for a larger study.

It is not clear if or when this application may be available, yet it is the first application I have seen for COPD that seems effective. Additional larger studies may allow other sites to try this new technology are hopeful.

Editor’s note: The ATS does not endorse any of the programs or products mentioned in this column.