Pre-post evaluation of healthcare resource utilization (HCRU) among patients with COPD enrolled in a digital health intervention

Abstract

<b>Rationale:</b> Digital interventions may support self-management and prompt early intervention in patients with COPD, possibly reducing HCRU. <b>Objective:</b> We evaluated the effect of a 6-month digital intervention on HCRU and medication use in patients with COPD. <b>Methods:</b> Patients with COPD were enrolled by their clinical pharmacist in a digital platform (Propeller Health), which included sensors to record inhaler medication use and maintenance medications reminders. Clinical pharmacists received alerts for patients with increased short-acting beta-agonist (SABA) use and/or low adherence to maintenance treatment to inform their outreach. Change in adherence (weekly maintenance puffs taken/prescribed), SABA use (puffs/week) and HCRU (oral corticosteroid prescription (OCS), ED and/or hospitalizations visits) for 6-months pre-post enrollment was assessed with mixed models. <b>Results:</b> 56 patients (mean age (SD): 75.6 (9.9) years) were enrolled. At baseline, patients used 9.6 SABA puffs/week and had a mean adherence of 79%. All-cause HCRU had a relative decline of 48% (95% CI: -74%, 5%; p = 0.07), with a 24% relative reduction in COPD-related OCS prescriptions (95% CI: -45%, 4%; p = 0.09), and a 45% relative reduction in COPD-related ED and hospitalizations (95% CI:-80%, 47%; p = 0.23) post-enrollment. At 6 months, there was a 47% (95% CI: -54, -38; p &lt; 0.001) relative reduction in mean weekly SABA use. Adherence declined somewhat but remained stable from months 3-6 (week 26: 61.5%). <b>Conclusion:</b> Over six months, we observed reductions in HCRU and stable use of maintenance medications in this digital self-management intervention.