An eHealth program to reduce hospitalizations due to acute exacerbation of chronic obstructive pulmonary disease – a real-life study

Abstract

Introduction: Hospitalization for acute exacerbation chronic obstructive pulmonary disease (COPD) is associated with poor prognosis. eHealth interventions might improve outcomes and decrease costs. This study aimed to evaluate the effect of an eHealth program on COPD exacerbations and hospitalizations. Methods: This was a real-life study from April 2018-December 2019 in the Bravis Hospital, the Netherlands. An eHealth program (EmmaCOPD), was offered to COPD patients at risk of exacerbations. EmmaCOPD consisted of a questionnaire application and physical activity coaching companion, aiming to recognize signs of an exacerbation. Patients and their informal caregivers received feedback if symptoms worsened or physical activity declined. Generalized Estimating Equations were used to compare the number of days admitted to the hospital and the number of severe exacerbations 12 months before and 12 months after the start of EmmaCOPD. Results: 29 patients were included, with a mean±SD forced expiratory volume in 1 second of 44.6±16.9 %predicted. In the year before the intervention, mean±SD number of severe exacerbations was 2.5±1.3. The mean±SD number of hospitalization days was 13.1±10.5. Afterward, it was 0.8±0.9 and 3.4±4.5 respectively. Preliminary results showed that after initiation of EmmaCOPD, both the number of severe exacerbations and the total number of hospitalization days significantly decreased (exp(B) 0.26 (95% CI: 0.16-0.41) and 0.21 (95% CI: 0.12-0.38)). Conclusion: The eHealth program seems to reduce the number of severe exacerbations and the number of days of hospitalization due to exacerbation COPD.