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Randomized Controlled Trial
. 2020 Jul 31;8(7):e18465.
doi: 10.2196/18465.

Development and Preliminary Evaluation of the Effects of an mHealth Web-Based Platform (HappyAir) on Adherence to a Maintenance Program After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

Begoña Jiménez-Reguera  1 , Eva Maroto López  2 , Shane Fitch  2 , Lourdes Juarros  3 , Marta Sánchez Cortés  3 , Juan Luis Rodríguez Hermosa  4 , Myriam Calle Rubio  4 , María Teresa Hernández Criado  5 , Marta López  5 , Santiago Angulo-Díaz-Parreño  1 , Aitor Martín-Pintado-Zugasti  1 , Jordi Vilaró  6
Affiliations
Randomized Controlled Trial

Development and Preliminary Evaluation of the Effects of an mHealth Web-Based Platform (HappyAir) on Adherence to a Maintenance Program After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

Begoña Jiménez-Reguera et al. JMIR Mhealth Uhealth. .

Abstract

Background: Pulmonary rehabilitation is one of the main interventions to reduce the use of health resources, and it promotes a reduction in chronic obstructive pulmonary disease (COPD) costs. mHealth systems in COPD aim to improve adherence to maintenance programs after pulmonary rehabilitation by promoting the change in attitude and behavior necessary for patient involvement in the management of the disease.

Objective: This study aimed to assess the effects of an integrated care plan based on an mHealth web-based platform (HappyAir) on adherence to a 1-year maintenance program applied after pulmonary rehabilitation in COPD patients.

Methods: COPD patients from three hospitals were randomized to a control group or an intervention group (HappyAir group). Patients from both groups received an 8-week program of pulmonary rehabilitation and educational sessions about their illness. After completion of the process, only the HappyAir group completed an integrated care plan for 10 months, supervised by an mHealth system and therapeutic educator. The control group only underwent the scheduled check-ups. Adherence to the program was rated using a respiratory physiotherapy adherence self-report (CAP FISIO) questionnaire. Other variables analyzed were adherence to physical activity (Morisky-Green Test), quality of life (Chronic Obstructive Pulmonary Disease Assessment Test, St. George's Respiratory Questionnaire, and EuroQOL-5D), exercise capacity (6-Minute Walk Test), and lung function.

Results: In total, 44 patients were recruited and randomized in the control group (n=24) and HappyAir group (n=20). Eight patients dropped out for various reasons. The CAP FISIO questionnaire results showed an improvement in adherence during follow-up period for the HappyAir group, which was statistically different compared with the control group at 12 months (56.1 [SD 4.0] vs 44.0 [SD 13.6]; P=.004) after pulmonary rehabilitation.

Conclusions: mHealth systems designed for COPD patients improve adherence to maintenance programs as long as they are accompanied by disease awareness and patient involvement in management.

Trial registration: ClinicalTrials.gov NCT04479930; https://clinicaltrials.gov/ct2/show/NCT04479930.

Keywords: COPD; adherence; chronic obstructive pulmonary disease; mHealth; pulmonary rehabilitation.

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Conflict of interest statement

Conflicts of Interest: This study was financed by the Board of Lovexair Foundation (HappyAir in intellectual property of the Lovexair Foundation); SF is its president. EM is an employee of the Lovexair Foundation.

Figures

Figure 1
Figure 1
Intervention and control group process and follow-up.
Figure 2
Figure 2
Distribution of patients Consolidated Standards of Reporting Trials flow diagram.
Figure 3
Figure 3
Adherence to HappyAir program: total dimension of CAP questionnaire.
Figure 4
Figure 4
Percentage of patients adherent to physical activity: Morisky Green questionnaire.
Figure 5
Figure 5
Relationship between mood state and physical activity.
Figure 6
Figure 6
Quality of life: Chronic Obstructive Pulmonary Disease Assessment Test questionnaire.
See this image and copyright information in PMC

References

    1. Celli BR, MacNee W, ATS/ERS Task Force Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004 Jun;23(6):932–946. doi: 10.1183/09031936.04.00014304. http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=15219010 - DOI - PubMed
    1. Fau LF. [The IBERPOC project: an epidemiological study of COPD in Spain. Scientific Committee of the IBERPOC study] Arch Bronconeumol. 1997 Jun;33(6):293–299. - PubMed
    1. Alcázar-Navarrete B, Trigueros JA, Riesco JA, Campuzano A, Pérez J. Geographic variations of the prevalence and distribution of COPD phenotypes in Spain: the ESPIRAL-ES study. Int J Chron Obstruct Pulmon Dis. 2018;13:1115–1124. doi: 10.2147/COPD.S158031. doi: 10.2147/COPD.S158031. - DOI - DOI - PMC - PubMed
    1. Miravitlles M. Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC)—Guía Española de la EPOC (GesEPOC) Arch Bronconeumol. 2012 Jan;48:2–58. doi: 10.1016/S0300-2896(12)70035-2. - DOI - PubMed
    1. Mantoani LC, Rubio N, McKinstry B, MacNee W, Rabinovich RA. Interventions to modify physical activity in patients with COPD: a systematic review. Eur Respir J. 2016 Jul;48(1):69–81. doi: 10.1183/13993003.01744-2015. http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=27103381 - DOI - PubMed

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