Assessing the Usefulness of the Prevexair Smartphone Application in the Follow-Up High-Risk Patients with COPD

Int J Chron Obstruct Pulmon Dis. 2021 Jan 8:16:53-65. doi: 10.2147/COPD.S279394. eCollection 2021.

Abstract

Introduction: This manuscript analyzes the exacerbations recorded by the Prevexair application through the daily analysis of symptoms in high-risk patients with COPD and explores its usefulness in assessing clinical stability with respect to that reported in visits.

Patients and methods: This study is a multi-centre cohort of COPD patients with the exacerbator phenotype who were monitored over 6 months. The Prevexair application was installed on the patients' smartphones. Patients used the app to record symptom changes, use of medication and use of healthcare resources. It is not established a recommended action plan when worsening of symptoms. At their clinical visit during the follow-up period, patients were asked about exacerbations suffered during these 6 months of monitoring. The investigators who conducted the visit were blinded about the Prevexair app records.

Results: The patients experienced a total of 185 exacerbations according to daily records in the app whereas only 64 exacerbations were recalled during medical visits. Perception became more accurate for severe exacerbations (kappa 0.6577), although we found no factors that predicted poor recall. The proportion of 72.5% patients were classified as unstable if the exacerbations captured by Prevexair were used to define stability, versus 47.8% if the exacerbations recall in visit was used. Two-thirds of the exacerbations recorded in the Prevexair application were not reported to doctors during their clinical visits. Almost half were treated with oral corticosteroids and/or antibiotics and more than one-quarter of the exacerbations treated did not seek medical attention.

Conclusion: The findings of this cohort study confirm that patients do not always remember the exacerbations suffered during their medical visit. The prevexair application is useful in monitoring COPD patients at high risk, in order to a better assessment of exacerbations of COPD during medical visits. Further research must be carried out to evaluate this strategy in clinical practice.

Keywords: chronic obstructive pulmonary disease; clinical prediction; electronic patient record; exacerbations; management; mobile health; telemonitoring.

MeSH terms

  • Adrenal Cortex Hormones
  • Cohort Studies
  • Disease Progression
  • Follow-Up Studies
  • Humans
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Smartphone

Substances

  • Adrenal Cortex Hormones

Grants and funding

This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). We thank AstraZeneca for its financial support with a donation to carry out the study. The financers had no role in study design, data collection, analysis, decision to publish or in the preparation of this manuscript. This does not alter our adherence to the Journal of Medical Internet Research policies on sharing data and materials.