Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 26:15:485.
doi: 10.1186/s12913-015-1135-2.

Oximetry-supported self-management for chronic obstructive pulmonary disease: mixed method feasibility pilot project

Michele MacNab  1 , Siew Hwa Lee  2 , Lucy McCloughan  3 , Janet Hanley  4 , Brian McKinstry  5 , Hilary Pinnock  6
Affiliations

Oximetry-supported self-management for chronic obstructive pulmonary disease: mixed method feasibility pilot project

Michele MacNab et al. BMC Health Serv Res. .

Abstract

Background: Pulse oximetry could potentially contribute to self-monitoring. NHS Lothian's 'Light Touch' service provided COPD patients with a self-management plan based on symptoms and oximetry. The service was overseen (though not actively monitored) by respiratory-trained community teams who were contactable by a telephone helpline. We aimed to assess the feasibility, perceived utility and impact of the 'Light Touch' service.

Methods: A before-and-after assessment of St George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS) and use of healthcare resources during the 6-month feasibility study compared to the previous corresponding 6-months. Paired semi-structured interviews with patients at baseline and 6-months, interviews with managers and a focus group of professionals explored perceptions of the service and self-management. Transcripts were coded, and analysed thematically.

Results: We recruited 51 participants (mean age 69.7 years (SD 8.4); 21 (46%) male). 46 participants completed quantitative follow up (2 died, 2 were unwell, 1 refused). SGRQ: 21 (46%) participants improved by 4 or more (the minimum important difference); 12 (26%) deteriorated by 4 or more. HADS: more participants had normal scores for anxiety (65%) and depression (80%) at 6-months than at baseline (51 and 64%). More emergency therapy was prescribed during the study period compared to the previous year. Only 18 participants (39%) contacted the Light Touch Helpline during the 6-month study. Twenty patients provided a total of 36 interviews, 8 clinicians contributed to a focus group and 6 managers were interviewed. Patients considered that the oximetry readings heightened awareness of their condition and gave them confidence to make self-management decisions. Healthcare professionals valued oximetry as a tool for teaching people self-management skills, but were concerned that patients rarely contacted the teams for help or advice during the study.

Conclusions: 'Light Touch' shows promise as a low-cost strategy for empowering patients' self-management skills and reducing reliance on clinical supervision.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Light Touch intervention
Fig. 2
Fig. 2
Consort diagram. Flow of patients through the study
Fig. 3
Fig. 3
Patient reported outcome measures
Fig. 4
Fig. 4
Examples of monitoring diaries
Fig. 5
Fig. 5
Primary and secondary health care use in the 6-month study compared with same 6 months the previous year
Fig. 6
Fig. 6
Proposed evolution of self-management
See this image and copyright information in PMC

References

    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128. doi: 10.1016/S0140-6736(12)61728-0. - DOI - PMC - PubMed
    1. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380:37–43. doi: 10.1016/S0140-6736(12)60240-2. - DOI - PubMed
    1. Seemungal TAR, Donaldson GC, Bhowmik A, Jeffires DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J of Respir Crit Care Med. 2000;161:1608–13. doi: 10.1164/ajrccm.161.5.9908022. - DOI - PubMed
    1. Seemungal TAR, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J of Respir Crit Care Med. 1998;157:1418–22. doi: 10.1164/ajrccm.157.5.9709032. - DOI - PubMed
    1. Liddell A, Adshead S, Burgess E. Technology in the NHS: transforming the patient’s experience of care. London: The King’s Fund; 2008.

Publication types