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
Multicenter Study
. 2022 Nov 17:17:2931-2944.
doi: 10.2147/COPD.S375049. eCollection 2022.

A Telemedicine Approach for Monitoring COPD: A Prospective Feasibility and Acceptability Cohort Study

Masahiro Shinoda  1 , Osamu Hataji  2 , Motohiko Miura  3 , Masaharu Kinoshita  4 , Akira Mizoo  5 , Kazunori Tobino  6 , Toru Soutome  7 , Takanobu Nishi  7 , Takeo Ishii  7 , Bruce E Miller  8 , Ruth Tal-Singer  8 , Ryan Tomlinson  8 , Taizo Matsuki  7 , Paul W Jones  9 , Yoko Shibata  10
Affiliations
Multicenter Study

A Telemedicine Approach for Monitoring COPD: A Prospective Feasibility and Acceptability Cohort Study

Masahiro Shinoda et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Telemedicine may help the detection of symptom worsening in patients with chronic obstructive pulmonary disease (COPD), potentially resulting in improved outcomes. This study aimed to determine the feasibility and acceptability of telemedicine among patients with COPD and physicians and facility staff in Japan.

Methods: This was a 52-week multicenter, prospective, single-arm, feasibility and acceptability cohort study of Japanese patients ≥40 years of age with COPD or asthma-COPD overlap. Participants underwent training to use YaDoc, a telemedicine smartphone App, which included seven daily symptom questions and weekly COPD Assessment Test (CAT) questions. The primary endpoint was participant compliance for required question completion. The secondary endpoint was participant and physician/facility staff acceptability of YaDoc based on questionnaires completed at Week 52. The impact of the Japanese COVID-19 pandemic state of emergency on results was also assessed.

Results: Of the 84 participants enrolled (mean age: 68.7 years, 88% male), 72 participants completed the study. Completion was high in the first six months but fell after that. Median (interquartile range [IQR]) compliance for daily questionnaire entry was 66.6% (31.0-91.8) and 81.0% (45.3-94.3) for weekly CAT entry. Positive participant responses to the exit questionnaire were highest regarding YaDoc ease of use (83.8%), positive impact on managing health (58.8%), and overall satisfaction (53.8%). Of the 26 physicians and facility staff enrolled, 24 completed the study. Of these, the majority (66.7%) responded positively regarding app facilitation of communication between physicians and participants to manage disease. Compliance was similar before and after the first COVID-19 state of emergency in Japan.

Conclusion: Daily telemedicine monitoring is potentially feasible and acceptable to both patients and physicians in the management of COPD. These results may inform potential use of telemedicine in clinical practice and design of future studies.

Clinical trial registration: JapicCTI-194916.

Keywords: Japan; acceptability; feasibility; patient-reported outcome measure; smartphone; telemonitoring.

PubMed Disclaimer

Conflict of interest statement

No authors received payment for the development of the manuscript. Masahiro Shinoda, Osamu Hataji, Motohiko Miura, Masaharu Kinoshita, Akira Mizoo and Kazunori Tobino report having received grants from the GSK group of companies for the conduct of this study. Osamu Hataji also reports personal fees from AstraZeneca, Novartis Pharma, and Boehringer Ingelheim for research funding consulting fee, outside the submitted work. Yoko Shibata reports having received personal fees from the GSK group of companies during the conduct of the study, and lecture fees from AstraZeneca, Novartis and Boehringer Ingelheim. Takanobu Nishi is an employee of GSK. Takeo Ishii, Ryan Tomlinson, Taizo Matsuki and Paul W Jones are employees of GSK and hold stocks/shares. Bruce E. Miller, Toru Soutome and Ruth Tal-Singer are former employees at the time of the study and shareholders of GSK. Ruth Tal-Singer is a Board member of ENA Respiratory and holds stock options from ENA Respiratory, she reports honorarium for conference talks from AAAAI and ATS, travel reimbursement from AAAAI, and personal fees from Immunomet, VOCALIS Health, ENA Respiratory, and Teva until January 2021. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study eligibility flow chart for (A) participants and (B) physicians and facility staff.
Figure 2
Figure 2
Kaplan-Meier plot showing survival curvea for (A) daily questionnaire entry completion and (B) weekly CAT entry completion. aAn event defined as the time to the last data entry date of the participant in which data was entered at least once.
Figure 3
Figure 3
Missing patterns of weekly CAT entry during (A) analysis week, and (B) real week from study initiation to study end.
Figure 4
Figure 4
Scatter plot comparing completion of daily questionnaire and weekly CAT entry during (A) first six months, (B) second six months, and (C) whole study.
Figure 5
Figure 5
Participant acceptability of the YaDoc platform according to their exit questionnairesa. an=80 for each question.
Figure 6
Figure 6
Physician and facility staff acceptability of the YaDoc platform according to their exit questionnairesa. an=24 for each question/statement.
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 pulmonary disease (2022 report); 2022. Available from: https://goldcopd.org/. Accessed November 4, 2022.
    1. Miravitlles M, Ribera A. Understanding the impact of symptoms on the burden of COPD. Respir Res. 2017;18(1):67. doi:10.1186/s12931-017-0548-3 - DOI - PMC - PubMed
    1. Anzueto A. Impact of exacerbations on COPD. Eur Respir Rev. 2010;19(116):113–118. doi:10.1183/09059180.00002610 - DOI - PMC - PubMed
    1. Ishii T, Nishimura M, Akimoto A, James MH, Jones P. Understanding low COPD exacerbation rates in Japan: a review and comparison with other countries. Int J Chron Obstruct Pulmon Dis. 2018;13:3459–3471. doi:10.2147/COPD.S165187 - DOI - PMC - PubMed
    1. Tamaki K, Sakihara E, Miyata H, et al. Utility of Self-administered questionnaires for identifying individuals at risk of COPD in Japan: the OCEAN (Okinawa COPD casE finding AssessmeNt) study. Int J Chron Obstruct Pulmon Dis. 2021;16:1771–1782. doi:10.2147/COPD.S302259 - DOI - PMC - PubMed

Publication types