A digital, self-management behavior change intervention for people with chronic obstructive pulmonary disease: cohort study

Background: People with chronic obstructive pulmonary disease (COPD) experience a range of limitations, which have a significant effect on their health. Self-management and pulmonary rehabilitation (PR) are key treatments for people with COPD; however, barriers often limit their uptake and adherence. Objective: To overcome these barriers, a digital self-management intervention called PocketMedic (PM) was developed and evaluated in people with COPD alongside, and in addition, to PR. Methods: A total of 53 participants were recruited to 1 of 3 groups: PM and PR, PM, or PR. Data were collected at baseline and 7 weeks (after the interventions had finished). Questionnaires on health-related quality of life, self-management knowledge, and disease knowledge were collected. Multivariate analysis of variances and ANOVAs were used to analyze the data. Results: The analyses found that the improvements in those receiving PM were not statistically significantly different from those receiving PR, indicating that PM may replicate the benefits underpinning self-management behaviors observed in those attending PR. However, there were no additional benefits when participants received PM and PR in combination. Conclusions: PM may be a useful treatment to support COPD self-management, especially when barriers prevent people with COPD receiving traditional services such as PR. The quantitative results suggest that PM may be less beneficial when delivered alongside PR. Feedback from participants indicated that they would prefer to receive PM while they were on the waiting list for PR, to support them during this time and alleviate the apprehensions associated with attending PR. Implications, limitations, and suggestions for future research are discussed. Trial Registration: ClinicalTrials.gov NCT03263754; https://clinicaltrials.gov/ct2/show/NCT03263754