Developing a cost-effective COPD self-management system that patients can use in hospital and at home
At a Glance
EDGE2 is a cohort study involving people with Chronic Obstructive Pulmonary Disease (COPD) who will each be given a digital home monitoring system. We intend to see how feasible it is to combine data collected by the digital system with data from hospital admissions. The overarching aim is to develop a cost-effective COPD self-management system that can be integrated in clinical care pathways that can benefit both patients and the NHS.
What is the EDGE COPD Self-management System?
The EDGE system was first developed and tested as part of the EDGE trial conducted between 2013 and 2015 (for more details of the trial click here). The system comprises a tablet-computer loaded with a digital health application (app) used to monitor symptoms, provide personalised information and guidance, and link to a pulse oximeter and a wrist-worn activity monitor. Patients are advised to complete a daily symptom diary and daily pulse oximetry readings (to measure oxygen saturation levels). Ongoing use allows the system to develop an accurate day-to-day profile of the patient’s health that can be reviewed by clinicians, whilst also providing the patient some insight about their health over time.
EDGE2 is based around the COPD self-management system developed and tested during the EDGE study.
The main study aim for EDGE2 is
- To determine the feasibility of integrating hospital data with patient data collected at home
- To link patient data obtained in hospital and at home to inform monitoring and the development of predictive algorithms.
Why IS THIS important?
Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory condition that affects 210 million people globally and an estimated 3 million people in the UK alone. COPD is a progressive disease with no cure. COPD is expected to become the third leading cause of death worldwide by 2020. In the UK, one in three patients with COPD are readmitted within 28 days of a hospital admission for an exacerbation (NICE). It is thought that 50% of costs for unplanned hospital admissions are potentially avoidable.
Current community care for COPD includes a coordinated plan for care (called a disease management package). Patients are educated about COPD and provided support for self-management, including smoking cessation help. Community care is delivered by community nursing staff and pulmonary rehabilitation programmes.
The EDGE COPD self-management system hopes to help promote effective self-management in the home without increasing the workload for the respiratory nursing team.
EDGE2 will recruit 200 participants over 2 years beginning in 2019*. All participants will be COPD patients who will have been admitted to Oxford University Hospitals for exacerbation of their COPD within the previous 90 days. Since the introduction of restrictions on face-to-face meetings due to COVID-19, EDGE2 has adapted to continue study procedures remotely.
Suitable patients will be identified by the Oxford Health NHS community respiratory team, who will provide the patient with details of the study and invite them to complete and return a contact form. Patients will then be contacted by a member of the research team and will provide their consent over the phone. Participants will be provided with the EDGE self-management system (tablet computer, pulse oximeter and wrist-worn acitivity monitor) via courier. Participants will complete a baseline quetionnaire and assessment over the phone and will receive an brief introduction to the system. Participants will be advised to use the system as much as they like. It is hoped participants will continue to use the tablet computer system regularly over the course of the study period. Participants will be visited at home or contacted by phone at 1 month, 3 months, 6 months and 12 months after consent. After 12 months, the EDGE system will be collected from the participant and their involvement in the study will come to an end. The data the participants input into the tablet computer will be linked with data generated during their initial hospital admission.
* Due to COVID-19, study recruitment was paused for the majority of 2020. An updated study timeline sees final recruitment in 2022.
How will this benefit patients?
Effective self-management of COPD, including the early recognition and treatment of exacerbations, has the potential to improve patient quality of life and reduce hospital admissions. Digital health interventions are increasingly seen as a way to bridge the gap between professional care and patient self-management.
Recruitment has now closed. EDGE2 is currently following up participants.