Improving out of hospital care of management of COPD exacerbations using health technology (COPD Predict App) in a novel way to identify exacerbations.

COPD (Chronic Obstructive Pulmonary Disease) exacerbation is the second most common cause for unplanned admissions. There is a clear national need for identifying exacerbations and treating them early which would reduce hospital admissions. COPD Predict pathway utilises an app which combines patient reported well-being questionnaire, home spirometry and point of care finger prick CRP test to identify patients at high risk of exacerbations through an AI enabled algorithm and treat them early. A six-month pilot (NIHR funded study) on 90 patients demonstrated significant benefits with high sensitivity for exacerbation prediction, positive patient engagement, reduction in hospitalisations and cost savings. We obtained feedback from patients through anonymous forms most of which have been positive. All patients found the use of the app and the handheld home spirometer device to be very easy, felt that being on the pathway improved the care of their condition, were very satisfied with the support provided by the COPD Predict team and felt confident that help was available when needed. Patients also felt that they were reassured because of specialist support from nursing staff and doctors. They felt that were in control of their condition by using the COPD Predict pathway. There was improvement in day-to-day symptoms as well as reduction in travel time and costs. As a result of this adapting this pathway, 84 admissions were avoided resulting in 737 bed days being saved. There is a good scope for replicating this across different trusts given the national need for reducing hospital admissions for exacerbation of COPD.