Assessment of the ADLIFE intervention as a digital solution for patients with advanced chronic diseases: a quasi-experimental trial

This multicentre, non-randomized, quasi-experimental study evaluated the effectiveness of the ADLIFE digital toolbox-comprising clinical decision support, care-plan management, and patient empowerment-for patients aged >55 with chronic obstructive pulmonary disease and chronic heart failure. Across four pilot sites (Spain, UK, Denmark, and Israel), 185 patients received the intervention and were compared with 185 retrospective standard-of-care control matched using propensity score. The primary outcome was the number of emergency room (ER) visits, analyzed through multivariate hurdle regression. Results in the pooled analysis (N = 370) indicated that while ADLIFE was associated with a significant reduction in the likelihood of an initial ER visit (OR 0.55; 95% CI: 0.31-0.96), no significant differences were found for subsequent visits among patients who had already utilized emergency services (IRR 1.74; 95% CI: 0.88-3.43). Significant effect heterogeneity was observed, with a reduction achieved in only one location (AMCA: OR 0.30; 95% CI: 0.15-0.63). These findings suggest that while digitally enabled care models hold potential for initial acute care prevention, their effectiveness is heavily contingent upon complex contextual factors. Given the small sample size and site-specific results, these data should be interpreted with caution. Trial registration: ClinicalTrials.gov; NCT05575336; September 2022.

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Publication Details

Journal
npj Digital Medicine
Published
2026-05-21
DOI
https://doi.org/10.1038/s41746-026-02716-0
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
Field-Weighted Citation Impact
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article

Assessment of the ADLIFE intervention as a digital solution for patients with advanced chronic diseases: a quasi-experimental trial

Miguel Ángel Ogueta Lana, Mustafa Yüksel, Marie Holm Sherman, Ana Ortega-Gil et al.
npj Digital Medicine
Chronic Obstructive Pulmonary Disease (COPD) Research
article

Assessment of the ADLIFE intervention as a digital solution for patients with advanced chronic diseases: a quasi-experimental trial

Miguel Ángel Ogueta Lana, Mustafa Yüksel, Marie Holm Sherman, Ana Ortega-Gil, Nerea González, Morven Miller, Urko Aguirre, Bunyamin Sarigül, Laura De la Higuera, Gil Levy, Dolores Verdoy, Anne Dichmann Sorknæs, Igor Larrañaga, Rachelle Kaye, Elinor Dahary Halevy, Theodoros N. Arvanitis, Nicolas Francisco Gonzalez Lopez, Lisa McCann, Oliver Groene, Borja García‐Lorenzo, Roma Maguire, Omid Pournik, Ania Gorostiza, Ane Fullaondo, Esteban de Manuel Keenoy, Bárbara López Perea, Juan De La Torre, Natassia Kamilla Juul, Michal Yeshayahu, Mikael Lilja, Itxaso Alayo, Gökhan Yilmaz, Gokce B Laleci Erturkmen, Anne Swoboda, Dipak Kalra, Angel Moro, Olga Vishnevetsky, Jose I. Aznar-Baranda, R Christensen, Hapal Randeva, Chao Tong, Remedios Vega, Jessica Caballero-García, Leire Ortiz de Elguea, Beñat Zubelzu, Tim Robbins, Michelle Yorkston, Gontzal Vallejo-Setién, Shramika Panchal, On behalf of the ADLIFE study group, Janika Bloemeke-Cammin
article en

Abstract

This multicentre, non-randomized, quasi-experimental study evaluated the effectiveness of the ADLIFE digital toolbox-comprising clinical decision support, care-plan management, and patient empowerment-for patients aged >55 with chronic obstructive pulmonary disease and chronic heart failure. Across four pilot sites (Spain, UK, Denmark, and Israel), 185 patients received the intervention and were compared with 185 retrospective standard-of-care control matched using propensity score. The primary outcome was the number of emergency room (ER) visits, analyzed through multivariate hurdle regression. Results in the pooled analysis (N = 370) indicated that while ADLIFE was associated with a significant reduction in the likelihood of an initial ER visit (OR 0.55; 95% CI: 0.31-0.96), no significant differences were found for subsequent visits among patients who had already utilized emergency services (IRR 1.74; 95% CI: 0.88-3.43). Significant effect heterogeneity was observed, with a reduction achieved in only one location (AMCA: OR 0.30; 95% CI: 0.15-0.63). These findings suggest that while digitally enabled care models hold potential for initial acute care prevention, their effectiveness is heavily contingent upon complex contextual factors. Given the small sample size and site-specific results, these data should be interpreted with caution. Trial registration: ClinicalTrials.gov; NCT05575336; September 2022.

npj Digital Medicine
Honda (Japan) (JP), University of Southern Denmark (DK), University of Strathclyde (GB), Gesundes Kinzigtal (Germany) (DE), Assuta Medical Center (IL), Odense University Hospital (DK), University Hospitals Coventry and Warwickshire NHS Trust (GB), Ghent University (BE), University of Warwick (GB), Hospital Alto Deba (ES), Biogipuzkoa Health Research Institute (ES), Red de Investigación en Actividades Preventivas y Promoción de la Salud (ES), Software Research and Development Consulting (TR), Ente Vasco de la Energía (ES), Hospital de Galdakao (ES), European Society for Therapeutic Radiology and Oncology (BE), Osakidetza (ES), Bioef - Fundación Vasca de Innovación e Investigación Sanitarias (ES), University of Birmingham (GB), Umeå University (SE)
European Commission, Horizon 2020
Peace, Justice and strong institutions
Openalex Percentile: Top 6%
Chronic Obstructive Pulmonary Disease (COPD) Research
DOIOpen Access PDFOpenAlex
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