Feasibility of RESP-FIT: Technology-Enhanced Self-Management Intervention for Adults with COPD

Abstract

Introduction

Chronic obstructive pulmonary disease (COPD) is associated with substantial functional morbidity, including activity-limiting symptoms such as dyspnea and fatigue. Self-management interventions aid in symptomatic management of COPD and have been shown to produce positive outcomes on quality of life (QOL) and reduce hospital admissions.

Purpose

The purpose of this randomized controlled longitudinal pilot study was to assess feasibility of the combined Respiratory Fitness (RESP-FIT) + Smartphone Airway Management System (SAMS) program, a 6-week, self-management, technology-enhanced respiratory muscle strength training (RMST) mHealth intervention.

Patients and Methods

Feasibility was assessed by evaluating recruitment, retention, acceptability, adherence, and safety data. Data were collected from 30 participants (15 in intervention group, 15 in control) at 3 time points (baseline, 6 weeks, and 14 weeks). The intervention group was requested to perform RMST at regular intervals during the week (5 breaths, 5 times a day, 5 days a week). Bluetooth enabled tracking was used to track training sessions. Data were analyzed using descriptive statistics.

Results

Recruitment was staggered for device usage and was completed in 57 weeks, with near 90% retention from baseline to end-of-intervention. Mobile application rating scale scores and interview data indicated moderate satisfaction. Participants completed 14,388 actions in the app. The most commonly used features were recording of daily symptoms via ecological momentary assessment (EMA) and tracking RMST if assigned to training sessions. Training days were successfully captured using EMA, but Bluetooth enabled training tracking was found to be not feasible. Overall, participants reported satisfaction with the RESP-FIT + SAMS mHealth intervention and found it acceptable.

Conclusion

RESP-FIT is feasible and enables real-time COPD symptom assessment in the home environment, but additional work is needed to integrate Bluetooth technology into the platform. Ongoing investigations focus on the accuracy of symptom perception, self-efficacy, and momentary factors that impact adherence behaviors.

Keywords:

• COPD
• self-management
• mobile health
• respiratory muscle strength training

Acknowledgments

This study was funded by the National Institutes of Health National Institute of Nursing Research (NIH/NINR) award number P20NR016575 and by the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, through NIH Grant Numbers UL1RR029882 and UL1TR000062. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIH/NINR.

Disclosure

Dr Charlie Strange reports personal fees from Glaxo Smith Kline, personal fees from Astra Zeneca, grants from Adverum, grants from MatRx, grants from Grifols, personal fees from CSL Behring, grants, personal fees from Takeda, personal fees from Dicerna, fees from AlphaNet as a Medical Director, grants, personal fees from Vertex, outside the submitted work. The authors declare no other conflict of interest.