Adherence in patients with COPD and heart failure using an eHealth self-management intervention

Abstract

Background: eHealth applications may be advocated as a feasible tool to implement self-management interventions for COPD patients. Poor adherence to inhaled medication and incorrect inhalation technique are however well-known phenomena. Objectives: To monitor self-reporting of symptoms and inhalation adherence with an eHealth self-management intervention in patients with COPD and heart failure. Methods: A total of 11 patients, recruited from two Dutch hospitals, participated in this prospective pilot study with a mean age of 67.3 ± 9.2. The majority of the patients had a diagnosis of severe COPD (54.5%) and had a reasonable left ventricle function (45.5%) (Ejection Fraction 41%-51%). Patients used an eHealth self-management intervention on which they completed a daily symptom diary that was linked to patient-tailored actions for symptom deterioration of COPD and heart failure. Sensorised inhalers were used to monitor adherence to inhaled medication and inhalation technique of seven patients. Results: Patients completed the daily symptom diary >80% up to 64 days of follow-up. Patients maintained average inhalation adherence rates of 97,4% (range 96,6 -100) during 15 weeks of follow-up. The total average of suboptimal, fair, and optimal inhalations was 31,3 % (range 0 – 85,7), 54,5% (range 14,2 – 71,4), and 11,6% (range 0 – 23,5), respectively. The majority showed little to no improvement in inhalation technique over time. Conclusion: Symptom reporting and inhaler adherence rates were high for the majority of patients. This suggests that the eHealth self-management intervention is a promising tool to routinely assess health outcomes in patients with COPD and heart failure.