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. 2018 Aug 24;6(8):e10502.
doi: 10.2196/10502.

An mHealth Management Platform for Patients with Chronic Obstructive Pulmonary Disease (efil breath): Randomized Controlled Trial

Hee Kwon  1 , Sungin Lee  1 , Eun Ji Jung  1 , SangHee Kim  2 , Jung-Kyu Lee  3 , Deog Kyeom Kim  3 , Tae-Hyung Kim  4 , Seung Hyeun Lee  5 , Myoung Kyu Lee  6 , Seungjae Song  1 , Kichul Shin  3
Affiliations

An mHealth Management Platform for Patients with Chronic Obstructive Pulmonary Disease (efil breath): Randomized Controlled Trial

Hee Kwon et al. JMIR Mhealth Uhealth. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is one of the major morbidities in public health, and the use of mHealth technology for rehabilitation of patients with COPD can help increase physical activity and ameliorate respiratory symptoms.

Objective: This study aimed to develop a comprehensive rehabilitation management platform to improve physical activity and quality of life in patients with COPD.

Methods: The study comprised the following 2 stages: (1) a pilot stage in which a prototype app was developed; and (2) a fully-fledged platform development stage in which 2 apps and 1 COPD patient monitoring website were developed. We conducted a randomized clinical trial to investigate the efficacy of the apps developed in the second stage of the study. In addition, two 12-week exercise regimens (fixed and fixed-interactive) were tested for the trial. The clinical parameters of the respiratory function and patient global assessment (PGA) of the app were obtained and analyzed. Notably, Android was the chosen operating system for apps.

Results: We developed 2 COPD rehabilitation apps and 1 patient monitoring website. For the clinical trial, 85 patients were randomized into the following 3 groups: 57 were allocated to the 2 intervention groups and 28 to the control group. After 6 weeks, the COPD assessment test scores were significantly reduced in the fixed group (P=.01), and signs of improvement were witnessed in the fixed-interactive group. In addition, the PGA score was moderate or high in all aspects of the user experience of the apps in both intervention groups.

Conclusions: A well-designed mobile rehabilitation app for monitoring and managing patients with COPD can supplement or replace traditional center-based rehabilitation programs and achieve improved patient health outcomes.

Trial registration: ClinicalTrials.gov NCT03432117; https://clinicaltrials.gov/ct2/show/NCT03432117 (Archived by WebCite at http://www.webcitation.org/71Yp0P64a).

Keywords: chronic obstructive pulmonary disease; mHealth; mobile phone; physical activity; quality of life; rehabilitation.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Study design. COPD: Chronic obstructive pulmonary disease; SMG-SNU: Seoul Metropolitan Government-Seoul National University.
Figure 2
Figure 2
Usability evaluation results (Stage 1).
Figure 3
Figure 3
Architecture of the home-based mobile COPD care service. PR: pulmonary rehabilitation; SpO2: blood oxygen saturation.
Figure 4
Figure 4
Fixed and interactive exercise regimens.
Figure 5
Figure 5
Walking exercise regimens: (1) fixed regimen and (2) interactive regimen.
Figure 6
Figure 6
Patient pulmonary rehabilitation record.
Figure 7
Figure 7
Study groups. IC: informed consent; a: Participants used fixed-regimen app; b: Participants used interactive-regimen app.
Figure 8
Figure 8
Respiratory function parameter changes and the patient global assessment of trial participants. PGA: patient global assessment; CAT: COPD assessment test; 6MWT: 6-minute walk test; mMRC: modified Medical Research Council; V1: baseline; V2: 6 weeks; V3: 12 weeks.
See this image and copyright information in PMC

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