Digital interventions for the management of chronic obstructive pulmonary disease

An international team of researchers from London, Anne Arbour and Melbourne have published a review on digital interventions for COPD. Author Rebecca Disler said "Evidence on digital interventions for COPD management was inconclusive. High heterogeneity and lack of detailed reporting calls for standardized efficacy testing and understanding of behavioral influences to make definitive judgements". The plain language summary is below.

What is COPD?

COPD is a chronic and progressive condition affecting the airways and lungs. Typically, COPD results from prolonged exposure to harmful chemicals found in tobacco smoke, leading to inflammation of the airways, as well as abnormal expansion of the airspaces of the lungs. Owing to the highly varied nature of COPD, there is much variety in how the condition affects individuals’ lives. A persistent cough and breathlessness are characteristic symptoms of COPD, worsening during flare‐ups (exacerbations) and becoming more severe over time. This makes activities of daily living more difficult and greatly impacts quality of life.

Managing COPD is complex and varies depending on the severity of the condition. Self‐management techniques often play a role in relieving symptoms, such as breathing exercises, as well as a combination of medication and supplementary oxygen.

'Digital interventions' and 'telehealth' are terms used to encompass the use of technology to communicate and send information between a patient and a healthcare provider ‐ helping to manage the patient’s condition remotely. This may involve (but is not restricted to) the use of a mobile phone or tablet computer application to log symptoms and lung function, allowing a clinician to adjust medications in real‐time. It may also involve remotely training a patient in self‐management techniques. There is scope for those living with COPD to greatly benefit from the use of such interventions, offering convenient and accessible healthcare provision.

Why did we do this review?

We wanted to find out if digital interventions were helpful for people with COPD in terms of managing their condition, and if these interventions played a part in changing their behaviour towards self‐management. Additionally, we wanted to understand the behaviour change techniques incorporated in different digital interventions.

What evidence did we find?

Mostly, digital interventions or multi component approaches did not improve walking distance or betterment in one's own belief in managing their condition. There was small short‐term improvement in quality of life with Internet‐based interventions but we cannot be certain whether the improvement is seen long term. Breathing difficulties may improve with long‐term use of digital interventions, but they may have little to no effect on flare‐ups. Due to limited data available, we cannot say with confidence that digital interventions can be used to improve health in people with COPD, or that they reduce harm. There is little or no evidence about possible unwanted side‐effects of digital interventions. More research in this field can provide more robust conclusions for their use and insight into people's behaviours towards these novel approaches.

The full review is available here.