Abstract
BackgroundPatients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses. Pulmonary rehabilitation (PR) can enhance exercise capacity of patients and it is crucial for patients to maintain a lifestyle which is long-term physically active. This study aimed to develop a home-based rehabilitation mHealth system incorporating behavior change techniques (BCTs) for COPD patients, and evaluate its technology acceptance and feasibility.MethodsGuided by the medical research council (MRC) framework the process of this study was divided into four steps. In the first step, the prescription was constructed. The second step was to formulate specific intervention functions based on the behavior change wheel theory. Subsequently, in the third step we conducted iterative system development. And in the last step two pilot studies were performed, the first was for the improvement of system functions and the second was to explore potential clinical benefits and validate the acceptance and usability of the system.ResultsA total of 17 participants were enrolled, among them 12 COPD participants completed the 12-week study. For the clinical outcomes, Six-Minute Walk Test (6MWT) showed significant difference (P = .023) over time with an improvement exceeded the minimal clinically important difference (MCID). Change in respiratory symptom (CAT score) was statistically different (P = .031) with a greater decrease of − 3. The mMRC levels reduced overall and showed significant difference. The overall compliance of this study reached 82.20% (± 1.68%). The results of questionnaire and interviews indicated good technology acceptance and functional usability. The participants were satisfied with the mHealth-based intervention.ConclusionsThis study developed a home-based PR mHealth system for COPD patients. We showed that the home-based PR mHealth system incorporating BCTs is a feasible and acceptable intervention for COPD patients, and COPD patients can benefit from the intervention delivered by the system. The proposed system played an important auxiliary role in offering exercise prescription according to the characteristics of patients. It provided means and tools for further individuation of exercise prescription in the future.
Highlights
Patients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses
In China, despite clinical guideline recommendations, poor perception, low referral and limited uptake rates were common among COPD patients [10] in addition to poor capability among primary health care providers (HCPs), and inconvenience regard to time or transportation [10, 11]
Polkey et al conducted a clinical trial that compared Tai Chi with conventional Pulmonary rehabilitation (PR) in COPD patients, the results showed that Tai Chi is equivalent to PR for improving SGRQ in COPD and demonstrated that Tai Chi is an appropriate substitute for PR in COPD in China [12]
Summary
Patients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses. Even with smoking cessation and pharmacological treatment, patients with COPD experience deficits in exercise capacity and physical activity as their disease progresses [3, 4]. It is crucial for patients to maintain a lifestyle which is long-term physically active to increase their exercise capacity, reduce dyspnea and improve their health-related quality of life (HRQL) [1, 5]. In China, despite clinical guideline recommendations, poor perception, low referral and limited uptake rates were common among COPD patients [10] in addition to poor capability among primary health care providers (HCPs), and inconvenience regard to time or transportation [10, 11]. There is an urgent need for promotion of PR, and for further development of more convenient and accessible strategies of PR to extend the initial benefits of PR in COPD patients
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