Using a digital support service can reduce the time patients with high-risk chronic obstructive pulmonary disease (COPD) spend in hospital each year, according to NHS researchers.
A study published this week in the International Journal of Chronic Obstructive Pulmonary Disease found that hospital admissions and bed days were both cut in half for people who used a digital support service.
COPD is a long-term progressive lung disease, which causes narrowing of the airways and makes it hard to breath. It affects more than 1.2 million people in the UK and almost 30,000 die from it each year.
The disease is predicted to cost the NHS £2.5 billion each year by 2030, mainly because of the expense of emergency hospital admissions due to COPD exacerbations.
However, researchers at NHS Greater Glasgow and Clyde (NHS GGC) found that providing patients with a digital support service could potentially relieve the burden on NHS services by reducing hospital admissions and days patients spend occupying hospital beds each year.
They assessed data from 83 patients with severe COPD after 12-24 months of access to a digital service co-designed with health tech firm Lenus Health, which included a patient app, clinician dashboard and support website.
The RECEIVER trial participants were able to input data about their symptoms and message clinicians through the app. They could also access self-management advice.
During the period observed, the number of hospital admissions and respiratory-related occupied bed days were reduced by around 50% for trial participants.
The digital service helps patients by reducing anxieties, providing clinical support, landing the interventions that reduce exacerbation frequency.Professor Chris Carlin, Consultant Respiratory Physician
In the year before using the digital service patients spent an average of 15 days in hospital beds, compared to just seven days the year after taking part in the trial.
Patients from a matched control cohort, who did not have access to the digital service, spent around five days a year more in hospital beds during the year after the study, with an average of 12 occupied bed days per patient.
Meanwhile, people using the digital service had around one hospital admission per year compared to more than 1.67 days for the control cohort.
NHS GGC consultant physician Professor Chris Carlin , who co-led the study, said: “The digital service helps patients by reducing anxieties, providing clinical support, landing the interventions that reduce exacerbation frequency and giving them the tools to recognise and either self-treat or get support for their flare-ups before they reach crisis point.”
Patients using the digital service also had a lower 12-month mortality rate of 16.9% compared to 24.1% in the control cohort.
The study’s publication coincides with a new report, from the Kings Fund which reveals the UK performs poorly on avoidable hospital admissions for COPD compared to similar countries.
Tackling health inequalities
Researchers highlighted that 58% of the study’s participants lived in the most socioeconomically deprived quintiles of the Scottish Index of Multiple Deprivation (SIMD), which accurately represents the typical COPD burden across the NHS GGC population.
The RECEIVER trial has demonstrated that engagement is consistent across the population with prevalence of the disease, which is reassuring.Professor David Lowe, Consultant in Emergency Medicine
NHS GGC consultant in emergency medicine Professor David Lowe who co-led the study, said: “It’s critical to demonstrate that the characteristics of the population that engage, adopt, and continue to use the digital service match the characteristics and prevalence of the disease within the population. The RECEIVER trial has demonstrated that engagement is consistent across the population with prevalence of the disease, which is reassuring.”
The study found that patients of all backgrounds engaged with the digital service and reported finding it easy to use.
Professor Carlin added: “This shows how digital can bridge some of the healthcare access divide, which is unusual for a clinical trial in a new technology.”
Sustained digital service use
One of the most surprising findings of the study, according to the researchers, was that patients continued to regularly use the digital service throughout the 12- 24 months of follow up. On average, patients were completing four daily COPD assessments tests (CAT) a week.
I was blown away by how useful patients found the service and how they easily adapted to using it regularly.Professor Chris Carlin, Consultant Respiratory Physician
Professor Carlin said: “I was blown away by how useful patients found the service and how they easily adapted to using it fairly regularly on a day-to-day basis.”
Another key finding was that patients using the digital service reported a consistent quality of life during the study.
This is despite COPD being a progressive disease which means that quality of life would usually be expected to decline over time.
Looking ahead, the study suggests there should be wider adoption of the digital COPD support service at other NHS organisations with continued clinical and economic evaluation underway in Hull.
Researchers at NHS GGC are also exploring, in a world-first investigation, how using artificial intelligence (AI) with the digital service could improve COPD management further.
Notes to Editors:
About NHS Greater Glasgow and Clyde
NHS Greater Glasgow and Clyde (NHS GGC) is the largest NHS organisation in Scotland and one of the largest in the UK, serving a population of 1.3 million people. It is responsible for providing and managing a whole range of health services including 35 hospitals across East Dunbartonshire, East Renfrewshire, Glasgow City, Inverclyde, Renfrewshire and West Dunbartonshire.
Visit the website: https://www.nhsggc.scot/
About Lenus Health
Lenus Health is leading predictive AI for the direct care of patients with chronic conditions. From diagnostic workflows to virtual wards to supported self-management, Lenus Health enables the proactive delivery of guideline-directed care to improve access and outcomes for patients.
Visit the website: https://lenushealth.com
About the RECEIVER trial
The Remote management of COPD: evaluating the implementation of digital innovations to enable routine care (RECEIVER) trial started in September 2019 and recruitment continued until March 2020. Data from the trial was censored on 31 August 2021, to allow for 12-24 months of follow-up.
Find out more here: https://www.dovepress.com/long-term-usage-and-improved-clinical-outcomes-with-adoption-of-a-copd-peer-reviewed-fulltext-article-COPD