SMART III: Chronic Obstructive Pulmonary Disease (COPD)

Self-Management supported by Assistive, Rehabilitation and Telehealth Technologies: (SMART) for Chronic Obstructive Pulmonary Disease (COPD)

University of Sheffield Team
Professor Mark Hawley | Project Lead) | mark.hawley@sheffield.ac.uk
Professor Gail Mountain (Project Lead) | g.a.mountain@sheffield.ac.uk

Claire Bentley (Research Associate and Project Manager) c.bentley@sheffield.ac.uk
Lauren Powell (Research Associate) l.a.powell@sheffield.ac.uk
Dr Stephen Potter (Translational Research Associate, CATCH) stephen.potter@sheffield.ac.uk
Dr Jack Parker (adviser) jack.parker@sheffield.ac.uk
Kiera Bartlett (adviser) kiera.bartlett@manchester.ac.uk

Background: The work follows on from the achievements of the SMART Consortium (http://thesmartconsortium.org/) in investigating the use of technology to help people with long term conditions to self-manage. The lessons learned from earlier projects will be extended to develop a new self-management program for COPD, a respiratory condition characterised by progressive decline in lung function. People with COPD may become housebound, socially isolated, depressed and may be admitted to hospital more frequently. These negative consequences of the condition can be reduced through effective self-management, for example by increasing physical activity and keeping an eye on symptoms. 

The current burden of COPD in the UK is around 1.5% of the population. COPD is a long term condition that leads to damaged airways, causing them to become narrow and making it harder for air to get into and out of the lungs. COPD affects one in six smokers aged over 45 years and is characterised by a chronic, progressive decline in lung function. As the disease progresses patients may become house-bound, socially isolated and depressed. Patients with COPD thus experience poor quality of life with impaired emotional, social and physical functioning. Exacerbations in symptoms occur with increasing frequency and often require hospital management.

Aims: The aim of the project is to produce and evaluate a piece of software which helps people with COPD to self-manage their condition. 

Project Summary: In general the project consists of three streams of work.  In Phase One ideas for a COPD self-management system (based on literature and earlier SMART work) have been discussed in interviews with COPD patients, their family members and relevant healthcare professionals to determine which features might be useful to include in the system.  Phase Two will involve the development of an early version of the COPD self-management system. During Phase Three this early version, or prototype, will be assessed on its usability and acceptability to people with COPD as a self-management tool.

Update (October, 2017): We are now testing our research methods to see if they are feasible for a larger future study and also the acceptability of the app. We have recruited 22 people so far and are looking to continue recruitment.  

Dissemination: Phase One results are now available! We interviewed 15 people with COPD, 5 family members and 7 healthcare professionals, and recommendations for the self-management system are summarised in this document.

We also visited Breathe Easy meetings across South Yorkshire to speak to people with COPD about the project and to let them know the results of Phase One.

Recommendations for the ‘Physical Activity and Functioning’ section of the system were presented at the King’s Fund International Digital Health and Care Congress in Sept 2014.


Further information can be found at: http://www.catch.org.uk/current-project/smart-copd/


CLAHRC Project Partners

University of Sheffield

Other Project Partners

Special thanks to South Yorkshire’s Breathe Easy groups (British Lung Foundation) and the Pulmonary Rehabilitation teams of NHS Sheffield, Rotherham and Doncaster. Most especially we wish to thank the participants in the research.    



Update (Nov 2018): 30 people with COPD have taken part in our feasibility study. We are currently analysing all data and writing up the results.

Update (October, 2017): We are now testing our research methods to see if they are feasible for a larger future study and also the acceptability of the app. We have recruited 22 people so far and are looking to continue recruitment. 

Update (Dec 2017): 22/30 patients recruited from Doncaster and Rotherham. Cath O'Connor and Rachel Cresswell joined the team to complete recruitment.

Update (Aug 2016): We are carrying out a feasibility study with Pulmonary Rehabilitation teams across South Yorkshire to find out whether the app is acceptable to patients and staff, and whether it would be feasible to use the app in this setting to help people with COPD increase their physical activity. Recruitment will begin Sept 2016.

Update (Nov 2015): Phases Two and Three are now complete. We have produced an app which works together with an activity monitor to encourage physical activity in COPD. We are going through approvals for a feasibility study to try out using the app with respiratory services across South Yorkshire.

Update (Feb 2015):  Phase One results summary here. Phases Two and Three (software development and usability testing) are ongoing.

Update (Dec 2017): 22/30 patients recruited from Doncaster and Rotherham. Cath O'Connor and Rachel Cresswell have joined the team to complete recruitment.

Impact

The research  formed a basis for determining whether the use of a telemonitoring system could increase self-management, reduce hospital admissions and improve quality of life for patients with early stage Chronic Obstructive Pulmonary Disease (COPD) who would be using this technology as part of their post hospital discharge support. Specifically, the pilot compared the use of a telehealth-supported Community COPD Service with the standard Community COPD Service. The study protocol was reviewed by the Consumers in Research Advisory Group (CRAG) prior to starting the research.

Dissemination

The results of the pilot trial have been published, and have informed NHS Barnsley’s strategy for rolling out telehealth to the wider Barnsley population.

Project Partners

CLAHRC partner organisations:
Barnsley Hospital NHS Foundation Trust (BHNFT)
NHS Barnsley (formerly Barnsley Primary Care Trust)

Other partner organisations
Barnsley Local Authority (LA)

Resources

The trial protocol has been published and is available through the Articles area of the Resources section, here.

The final results are available here