Effect on health status of integrated self-management platforms in COPD disease-management

Abstract

Introduction: COPD self-management through eHealth is effective to improve the quality of integrated disease management (IDM). Nevertheless, adoption of eHealth stays behind with implementation problems. Aim: to analyze the influence of eHealth implementation on the health status of COPD patients in primary care, using the Clinical COPD Questionnaire (CCQ). Methods: The e-Vita COPD study compared 3 levels of integration of self-management platforms in IDM (high, medium, non) and randomization of 2 levels of personal assistance for patients (high and low). Interrupted time series (ITS) design was used to collect CCQ data at multiple time points (before/after intervention) and multilevel linear regression modelling to analyze CCQ data before and after intervention. Results: Of the 702 invited COPD patients, 215 registered to a platform. 82 participated in group 1 (high integration); 36 with high, 46 with low assistance. 96 participated in group 2 (medium integration); 44 with high, 52 with low assistance. 37 participated in group 3 (no integration, no assistance). In the total group, no significant difference was found in CCQ-trend (p=0.334) before (-0.47% per month) and after intervention (-0.084% per month). No significant difference was found in CCQ changes before vs. after intervention between groups with high vs. low personal assistance (p=0.429). In all subgroups, there was no significant change in the CCQ trend before and after intervention. Conclusion: The e-Vita intervention had no beneficial impact on health status of COPD patients. No differences were found between different levels of integration or between patients receiving different levels of personal assistance.