Introduction:
Millions of people worldwide suffer from chronic obstructive pulmonary disease but have never been diagnosed with the disease and met appropriate medical attention and treatment. Chronic obstructive pulmonary disease (COPD), is a progressive disorder of the lungs wherein there is a blockage to airflow and trouble breathing. It involves bronchitis and emphysema. There is no complete cure for the disorder. However, it can be controlled by proper therapy, which will enable the patient to lead a healthy and productive life. Several medications are available for the management of chronic obstructive pulmonary disease. However, their effects are limited and need to be balanced against the adverse effects and the cost of medications.
Bronchodilators are administered through puffers or spacers, and pulmonary rehabilitation can improve the quality of life. Continued studies on the disease have led to the evaluation of newer therapies like lung volume reduction surgery, anti-inflammatory drugs, and non-invasive ventilation. Another recent intervention is the introduction of digitized tools for managing and preventing symptoms and exacerbation of COPD. Yes, digital tools can improve patient outcomes in chronic obstructive pulmonary disease. It provides patients with education and resources to understand their condition better and help them manage it. Additionally, digital tools will help track the symptoms, provide medication reminders, and educate patients about the strategies to help manage their COPD. All these strategies can have a positive impact on patient outcomes.
Can Digital Tools Improve the Patient Outcome in Chronic Obstructive Pulmonary Disease?
With emerging digital technologies, patients with chronic obstructive pulmonary disease are presented with many options to manage the disease outside the physician's office. Eventually, the aim is to improve patient outcomes. One of the most important digital tools that the patient can use is the pulse oximeter. In addition to self-monitoring, they can be integrated into telemedicine appointments so that the physician can understand the patient's status remotely. However, most of the studies and research on digital tools are inconclusive, and more evidence supporting their benefits is yet to be available to date.
A pilot study in 2022 has shown that the use of smart versions of the spirometer, pulse oximeter, and nebulizers by the patient without medical assistance has resulted in high patient satisfaction and engagement, with the participants perceiving the tools as easy to use and valuable.
Another study in 2019 found that patients could report the symptoms with the help of an eHealth self-management online application that delivered treatment advice depending upon the detection of exacerbations and symptoms. However, a review conducted in 2021 concluded that more than evidence is needed to determine the pros and cons of using digital tools to manage COPD, though a short-term improvement in dyspnea and the quality of life is noted after the long-term use of digital technologies.
Similarly, a systematic review and meta-analysis conducted in 2020 revealed that using mobile health apps for COPD patients had inconsistent results compared to conventional care. These inconsistencies in the outcomes of various studies recommend a uniform framework for reviewing outcomes in further studies on the self-management of chronic obstructive pulmonary disease using digital interventions.
What Are the Current Digital Interventions for COPD Self-Management?
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Self-monitoring of chronic obstructive pulmonary disease at home is slowly gaining popularity and has increased its pace during the pandemic. A variety of digital approaches are currently recommended in clinical practice by physicians to help evaluate the individual signs and symptoms in people with chronic obstructive pulmonary disease to improve overall disease management. Several devices and applications have been introduced to improve symptom management and communication, improving care, mindfulness, and patient support.
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Most COPD patients are now familiar with home pulse oximeters. Digital spirometers are also now easily available in the market.
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In addition to home oximeters and spirometers, recent digital tools include wearable devices that can measure heart rate, activity levels, stress, and many more parameters; sensors and related smartphone applications are available to detect air quality and display it in the app. Digital metered dose inhalers can record medication compliance. Other technologies include
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Personal spirometers paired with a mobile application that can measure peak flow and forced expiratory volume.
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Mobile application to educate the patients about COPD breathing techniques.
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Personalized health and self-management application for COPD patients.
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Digital peak flow meters.
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Remote pulmonary rehabilitation.
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COPD medication management mobile application.
How Effective Are the Digital Tools for COPD Self-Management?
Clinicians from their practice have observed for most of the cases that, with the use of self-management tools, the patient seems to be more engaging. They enjoy their ability to monitor their disease state, which gives them a feeling of control over the disease. Though enough evidence supporting the effectiveness of digitized tools is not yet available, several pulmonologists strongly believe that digital therapeutics can be highly effective in detecting exacerbation and preventing several unscheduled clinic visits and hospitalization. Better access to pulmonary rehabilitation is also obtained through digital COPD solutions.
Patient satisfaction while using digital technology comes with its feasibility and ease of use. In addition, the patient may require some training. They have a positive attitude towards this intervention, specifically when the applications and devices are easy to use and can benefit the patients in achieving their health goals. However, a few barriers in the digital practice are less economical, as the technology always comes with a cost and may not be feasible for all classes of patients; some patients might find it difficult to comprehend the technical use of the apps and devices due to lack of knowledge. Due to the lack of enough evidence on the safety and effectiveness of digital devices, further studies and extensive research are needed in this field.
Conclusion:
COPD patients are living with a constant risk of day-to-day uncontrolled symptoms and chances of exacerbations, decreasing the quality of their life and increasing morbidity and mortality. In addition to providing appropriate medical and clinical interventions, much more is required to lessen the gaps and improve the quality of living. The digitized tools let the patient self-monitor their symptoms and allow the clinician to intervene earlier to provide better patient care and reduce hospitalizations.
