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Randomized Controlled Trial
. 2017 Jul 21;19(7):e264.
doi: 10.2196/jmir.6743.

Evaluating a Web-Based Coaching Program Using Electronic Health Records for Patients With Chronic Obstructive Pulmonary Disease in China: Randomized Controlled Trial

Lan Wang  1 , Lin He  2 , Yanxia Tao  1 , Li Sun  3 , Hong Zheng  4 , Yashu Zheng  4 , Yuehao Shen  5 , Suyan Liu  5 , Yue Zhao  1 , Yaogang Wang  3
Affiliations
Randomized Controlled Trial

Evaluating a Web-Based Coaching Program Using Electronic Health Records for Patients With Chronic Obstructive Pulmonary Disease in China: Randomized Controlled Trial

Lan Wang et al. J Med Internet Res. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is now the fourth leading cause of death in the world, and it continues to increase in developing countries. The World Health Organization expects COPD to be the third most common cause of death in the world by 2020. Effective and continuous postdischarge care can help patients to maintain good health. The use of electronic health records (EHRs) as an element of community health care is new technology in China.

Objective: The aim of this study was to develop and evaluate a Web-based coaching program using EHRs for physical function and health-related quality of life for patients with COPD in China.

Methods: A randomized controlled trial was conducted from 2008 to 2015 at two hospitals. The control group received routine care and the intervention group received routine care with the addition of the Web-based coaching program using EHRs. These were used to manage patients' demographic and clinical variables, publish relevant information, and have communication between patients and health care providers. Participants were not blinded to group assignment. The effects of the intervention were evaluated by lung function, including percent of forced expiratory volume in 1 second (FEV1%), percent of forced vital capacity (FVC%), peak expiratory flow (PEF), maximum midexpiratory flow; St George's Respiratory Questionnaire (SGRQ); Modified Medical Research Council Dyspnea Scale (MMRC); and 6-Minute Walk Test (6MWT). Data were collected before the program, and at 1, 3, 6, and 12 months after the program.

Results: Of the 130 participants, 120 (92.3%) completed the 12-month follow-up program. There were statistically significant differences in lung function (FEV1%: F1,4=5.47, P=.002; FVC%: F1,4=3.06, P=.02; PEF: F1,4=12.49, P<.001), the total score of SGRQ (F1,4=23.30, P<.001), symptoms of SGRQ (F1,4=12.38, P<.001), the activity of SGRQ (F1,4=8.35, P<.001), the impact of SGRQ (F1,4=12.26, P<.001), MMRC (F1,4=47.94, P<.001), and 6MWT (F1,4=35.54, P<.001) between the two groups with the variation of time tendency.

Conclusions: The Web-based coaching program using EHRs in China appears to be useful for patients with COPD when they are discharged from hospital into the community. It promotes the sharing of patients' medical information by hospital and community nurses, and achieves dynamic management and follow-up analysis for patients' disease. In addition, this program can postpone the decreasing rate of lung function, improve quality of life, decrease dyspnea, and increase physical capacity.

Keywords: Web-based coaching program; chronic obstructive pulmonary disease; electronic health records.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT flow diagram.
Figure 2
Figure 2
Participant log-in process.
Figure 3
Figure 3
Administrator log-in process.
See this image and copyright information in PMC

References

    1. Global Initiative for Chronic Obstructive Lung Disease: Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease (Updated 2016) Leuven, Belgium: Global Initiative for Chronic Obstructive Lung Disease; 2016.
    1. Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, Stockley RA, Sin DD, Rodriguez-Roisin R. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013 Feb 15;187(4):347–365. doi: 10.1164/rccm.201204-0596PP. - DOI - PubMed
    1. Kandula NR, Puri-Taneja A, Victorson DE, Dave SS, Kanaya AM, Huffman MD. Mediators of atherosclerosis in south asians living in America: use of web-based methods for follow-up and collection of patient-reported outcome measures. JMIR Res Protoc. 2016;5(2):e95. doi: 10.2196/resprot.5448. http://www.researchprotocols.org/2016/2/e95/ - DOI - PMC - PubMed
    1. Smit E, Evers S, de Vries H, Hoving C. Cost-effectiveness and cost-utility of Internet-based computer tailoring for smoking cessation. J Med Internet Res. 2013 Mar 14;15(3):e57. doi: 10.2196/jmir.2059. http://www.jmir.org/2013/3/e57/ - DOI - PMC - PubMed
    1. Payne TH. The electronic health record as a catalyst for quality improvement in patient care. Heart. 2016 Aug 08;:e1. doi: 10.1136/heartjnl-2015-308724. - DOI - PubMed

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