Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised with acute exacerbations. This is a common cause of emergency admission to hospital and costs the NHS nearly £2 billion a year. Nearly half of patients are discharged within 3 days of admission but a quarter of patients are readmitted within 30 days of discharge. To further complicate COPD management, nearly three quarters of patients have additional comorbidities and the prevalence of comorbid conditions increases with more advanced disease. Intervening on hospitalised patients could be ideal timing to support the hospital-to-home pathway in preventing readmission.
Using the EDGE system, patients can complete symptom diaries, measure their oxygen saturation levels and pulse daily, and wear a physical activity monitor, with all output monitored remotely by a clinical team, who are alerted to sustained, abnormal values. Personalised videos encouraging good inhaler technique and self-care facilitate engagement with the device. Patient feedback indicates that using the system is acceptable to patients and healthcare teams.
We previously successfully developed the system with patients in the community and we have subsequently moved to identifying patients with COPD in hospital to allow linkage of data from hospital and the support tool around admission for acute exacerbations. The current study is exploring the feasibility of recruiting from a hospital setting and the system’s acceptability to patients and healthcare professionals.