TY  - JOUR
AU  - Chen, Jessica
AU  - Kaye, Leanne
AU  - Tuffli, Michael
AU  - Barrett, Meredith A
AU  - Jones-Ford, Shelanda
AU  - Shenouda, Tina
AU  - Gondalia, Rahul
AU  - Henderson, Kelly
AU  - Combs, Veronica
AU  - Van Sickle, David
AU  - Stempel, David A
PY  - 2019
DA  - 2019/10/23
TI  - Passive Monitoring of Short-Acting Beta-Agonist Use via Digital Platform in Patients With Chronic Obstructive Pulmonary Disease: Quality Improvement Retrospective Analysis
JO  - JMIR Form Res
SP  - e13286
VL  - 3
IS  - 4
KW  - chronic obstructive pulmonary disease
KW  - telemedicine
KW  - quality improvement, feasibility
KW  - nebulizers and vaporizers
KW  - health services
AB  - 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. 
SN  - 2561-326X
UR  - http://formative.jmir.org/2019/4/e13286/
UR  - https://doi.org/10.2196/13286
UR  - http://www.ncbi.nlm.nih.gov/pubmed/31647471
DO  - 10.2196/13286
ID  - info:doi/10.2196/13286
ER  -