Optimizing Treatment for Hospitalized Patients with COPD: A Study on the Impact of a LINE App-Based Multidisciplinary Team Approach Targeting Pharmacological Treatment, Lifestyle Changes, and Smoking Cessation

Hsiang-Yu Huang,1,&ast; Chia-Ling Chen,2,&ast; Yi-Ling Lin,3 Shu-Chuan Chen,4 Li-Chu Lee,4 Huei-Min Dai,4 Cheng-Yang Chiang,5 Yu-Fan Chang,6 Hsiu Lu,7 Mung-Rung Lee,7 Chih-Chiao Yang,8 Chiu-Hui Su,9 Ying-Zhen Chiang,10 Mei-Chen Yang,2,11 Rong-Yaun Shyu,12 Chou-Chin Lan2,11 1Division of Respiratory Therapy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 2Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 3Department of Planning and Management, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 4Department of Nursing, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 5Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 6Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 7Center of Community and Long-term Care Services, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 8Department of Social Services, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 9Center of Chest Medicine Examination, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 10Center of Quality Management, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China; 11School of Medicine, Tzu-Chi University, Hualien, Taiwan, Republic of China; 12Division of Gastroenterology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China&ast;These authors contributed equally to this workCorrespondence: Chou-Chin Lan, Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian City, New Taipei City, 23142, Taiwan, Republic of China, Tel +886-2-6628-9779 ext. 2259, Fax +886-2-6628-9009, Email [email protected] Rong-Yaun Shyu, Division of Gastroenterology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian City, New Taipei City, 23142, Taiwan, Republic of China, Tel +886-2-6628-9779 ext. 8119, Fax +886-2-6628-9009, Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition that significantly impacts patients’ health status. Effective management requires a multidisciplinary team (MDT) to address pharmacological and non- pharmacological treatments. The integration of mobile apps and devices improves COPD management by reducing symptoms and exacerbations. LINE, a commonly used communication app, enhanced team coordination and real-time decision-making. This study explored the effectiveness of LINE-based MDT interventions in hospitalized patients with COPD.Methods: This retrospective analysis included patients with COPD admitted for exacerbations and compared their outcomes before and after the implementation of LINE-based MDT care. The MDT consisted of pulmonologists, care managers, nurses, dietitians, social workers, pharmacists, respiratory therapists, and long-term care teams. A LINE group coordinated care in real-time, enabling the team to promptly review the patients’ conditions, adjust treatment plans, and provide tailored interventions.Results: The LINE-based MDT group demonstrated significantly higher intervention rates, including systemic steroids, inhaled corticosteroids, long-acting beta-agonists, long-acting muscarinic antagonists, and pulmonary rehabilitation (p< 0.05). BSRS improvement was greater in the MDT group than the non-MDT group (40.9% vs 29.7%, p = 0.016). However, there were no significant differences between the groups’ readmission rates, emergency room visits, or one year survival (p> 0.05).Conclusion: Implementing LINE-based MDT care significantly improved the delivery of pharmacological and non-pharmacological interventions, enhanced coordination, and facilitated comprehensive management, leading to better quality of life outcomes, as evidenced by improvements in BSRS scores. This highlights the value of leveraging real-time communication tools like LINE app to optimize COPD care.Keywords: chronic obstructive pulmonary disease, multidisciplinary team, health-related quality of life, LINE-based