Using a digital support service can reduce the time patients with high-risk chronic obstructive pulmonary disease (COPD) spend in hospital each year, NHS researchers have learned.
Research published this week in the International Journal of Chronic Obstructive Pulmonary Disease found that hospital admissions and bed days were both cut in half for people who used a digital support service.
COPD is a long-term progressive lung disease, which causes narrowing of the airways and makes it hard to breathe.
The condition affects more than 1.2 million people in the UK and almost 30,000 die from it each year.
COPD is predicted to cost the NHS £2.5 billion each year by 2030, mainly because of the expense of emergency hospital admissions due to COPD exacerbations.
However, researchers at NHS Greater Glasgow and Clyde (NHS GGC) found that providing patients with a digital support service could potentially relieve the burden on NHS services by reducing hospital admissions and the number of days patients spend occupying hospital beds each year.
The researchers assessed data from 83 patients with severe COPD after 12-24 months of access to a digital service co-designed with health tech firm Lenus Health, which included a patient app, clinician dashboard and support website.
The RECEIVER trial participants were able to input data about their symptoms and message clinicians via the app. The participants could also access self-management advice.
During the period observed, the number of hospital admissions and respiratory-related occupied bed days were reduced by around 50 per cent for trial participants.
In the year before using the digital service, patients spent an average of 15 days in hospital beds, compared to seven days the year after taking part in the trial.
Patients from a matched control cohort, who did not have access to the digital service, spent around five days per year more in hospital beds during the year after the study, with an average of 12 occupied bed days per patient.
Meanwhile, people using the digital service had around one hospital admission each year compared to more than 1.67 days for the control cohort.
NHS GGC consultant physician Professor Chris Carlin , who co-led the study, said: “The digital service helps patients by reducing anxieties, providing clinical support, landing the interventions that reduce exacerbation frequency and giving them the tools to recognise and either self-treat or get support for their flare-ups before they reach crisis point.”
Patients using the digital service also had a lower 12-month mortality rate of 16.9 per cent compared to 24.1 per cent in the control cohort.
The publication of the study coincides with a new report, from the Kings Fund which reveals the UK performs poorly on avoidable hospital admissions for COPD compared to similar countries.
Tackling health inequalities
Researchers highlighted that 58 per cent of the study’s participants lived in the most socioeconomically deprived quintiles of the Scottish Index of Multiple Deprivation (SIMD), which accurately represents the typical COPD burden across the NHS GGC population.
NHS GGC consultant in emergency medicine Professor David Lowe who co-led the study, said: “It’s critical to demonstrate that the characteristics of the population that engage, adopt, and continue to use the digital service match the characteristics and prevalence of the disease within the population.
“The RECEIVER trial has demonstrated that engagement is consistent across the population with prevalence of the disease, which is reassuring.”
The study found that patients from all backgrounds engaged with the digital service and reported finding it easy to use.
Dr Carlin added: “This shows how digital can bridge some of the healthcare access divide, which is unusual for a clinical trial in a new technology.”
Sustained digital service use
One of the most surprising findings of the study, the researchers said, was that patients continued to regularly use the digital service throughout the 12- 24 months of follow up.
On average, patients were completing four daily COPD assessments tests (CAT) per week.
Dr Carlin said: “I was blown away by how useful patients found the service and how they easily adapted to using it fairly regularly on a day-to-day basis.”
The study also found that patients using the digital service reported a consistent quality of life during the study.
This is despite COPD being a progressive disease which means that quality of life would typically decline over time.
Looking ahead, the research suggests there should be wider adoption of the digital COPD support service at other NHS organisations with continued clinical and economic evaluation underway in Hull.
Researchers at NHS GGC are also exploring, in a world-first investigation, how using AI with the digital service could improve COPD management further.
