@Article{info:doi/10.2196/13286,
author="Chen, Jessica
and Kaye, Leanne
and Tuffli, Michael
and Barrett, Meredith A
and Jones-Ford, Shelanda
and Shenouda, Tina
and Gondalia, Rahul
and Henderson, Kelly
and Combs, Veronica
and Van Sickle, David
and Stempel, David A",
title="Passive Monitoring of Short-Acting Beta-Agonist Use via Digital Platform in Patients With Chronic Obstructive Pulmonary Disease: Quality Improvement Retrospective Analysis",
journal="JMIR Form Res",
year="2019",
month="Oct",
day="23",
volume="3",
number="4",
pages="e13286",
keywords="chronic obstructive pulmonary disease; telemedicine; quality improvement, feasibility; nebulizers and vaporizers; health services",
abstract="Background: Digital health programs assist patients with chronic obstructive pulmonary disease (COPD) to better manage their disease. Technological and adoption barriers have been perceived as a limitation. Objective: The aim of the research was to evaluate a digital quality improvement pilot in Medicare-eligible patients with COPD. Methods: COPD patients were enrolled in a digital platform to help manage their medications and symptoms as part of their routine clinical care. Patients were provided with electronic medication monitors (EMMs) to monitor short-acting beta-agonist (SABA) use passively and a smartphone app to track use trends and receive feedback. Providers also had access to data collected via a secure website and were sent email notifications if a patient had a significant change in their prescribed inhaler use. Providers then determined if follow-up was needed. Change in SABA use and feasibility outcomes were evaluated at 3, 6, and 12 months. Results: A total of 190 patients enrolled in the pilot. At 3, 6, and 12 months, patients recorded significant reductions in daily and nighttime SABA use and increases in SABA-free days (all P<.001). Patient engagement, as measured by the ratio of daily active use to monthly active use, was >90{\%} at both 6 and 12 months. Retention at 6 months was 81{\%} (154/190). Providers were sent on average two email notifications per patient during the 12-month program. Conclusions: A digital health program integrated as part of standard clinical practice was feasible and had low provider burden. The pilot demonstrated significant reduction in SABA use and increased SABA-free days among Medicare-eligible COPD patients. Further, patients readily adopted the digital platform and demonstrated strong engagement and retention rates at 6 and 12 months. ",
issn="2561-326X",
doi="10.2196/13286",
url="http://formative.jmir.org/2019/4/e13286/",
url="https://doi.org/10.2196/13286",
url="http://www.ncbi.nlm.nih.gov/pubmed/31647471"
}