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Anna Taylor,1 Andrew Cushing,2 Morgan Dow,2 Jacqueline Anderson,1 Grace McDowell,1 Stephanie Lua,1 Maureen Manthe,1 Sandosh Padmanabhan,3 Shane Burns,2 Paul McGinness,2 David J Lowe,1,4 Christopher Carlin1 1Departments of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, Scotland; 2Lenus Health Ltd, Edinburgh, Scotland; 3Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland; 4Institute of Health and Wellbeing, University of Glasgow, Glasgow, ScotlandCorrespondence: Christopher Carlin, Department of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, Scotland, Tel + 44 141 451 6088, Email christopher.carlin@ggc.scot.nhs.ukPurpose: Digital tools may improve chronic obstructive pulmonary disease (COPD) management, but further evidence of significant, persisting benefits are required. The RECEIVER trial was devised to evaluate the Lenus COPD support service by determining if people with severe COPD would continue to utilize the co-designed patient web application throughout study follow-up and to explore the impact of this digital service on clinical outcomes with its adoption alongside routine care.Patients and Methods: The prospective observational cohort hybrid implementation-effectiveness study began in September 2019 and included 83 participants. Recruitment stopped in March 2020 due to COVID-19, but follow-up continued as planned. A contemporary matched control cohort was identified to compare participant clinical outcomes with and minimize biases associated with wider COVID-19 impacts. Utilization was determined by daily COPD assessment test (CAT) completion through the application. Survival metrics and post-index date changes in annual hospitalizations were compared between the RECEIVER and control cohorts. Longitudinal quality of life and symptom burden data and community-managed exacerbation events were also captured through the application.Results: High and sustained application utilization was noted across the RECEIVER cohort with a mean follow-up of 78 weeks (64/83 participants completed at least one CAT entry on ≥ 50% of possible follow-up weeks). Subgroup analysis of participants resident in more socioeconomically deprived postcode areas revealed equivalent utilization. Median time to death or a COPD or respiratory-related admission was higher in the RECEIVER cohort compared to control (335 days vs 155 days). Mean reduction in annual occupied bed days was 8.12 days vs 3.38 days in the control cohort. Quality of life and symptom burden remained stable despite the progressive nature of COPD.Conclusion: The sustained utilization of the co-designed patient application and improvements in participant outcomes observed in the RECEIVER trial support scale-up implementation with continued evaluation of this digital service.Keywords: COPD, self-management, remote monitoring, patient-reported outcomes |
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