None listed
Conditions
Brief summary
The objective is to investigate whether new technologies can reduce days of hospitalisation for high-risk patients with COPD. A randomised controlled trial will be conducted with Counties Manukau DHB, Southland DHB and Gore Health. Sixty participants will be randomised to receive either standard care, or standard care plus a robot. The robot will be programmed to provide medication management, telemedicine, spirometer readings and blood oxygen monitoring, monitoring of activity using wearable activity sensors, COPD questionnaires, and be linked to Smart inhaler devices to monitor adherence. The data from the robot and smart inhalers will be monitored and if the early signs of an exacerbation are detected, appropriate treatment will be provided to patients. The hypotheses are that telehealthcare (the robot) will reduce hospital admissions and bed-care days compared to a control group, as well as improvements in mental health, loneliness, and adherence. This research will deliver information about the clinical- and cost-effectiveness of these technologies to inform COPD care.
Interventions
The intervention is in the form of a robot that reminds people to take medication and do exercises, and measures spirometry, weight, pulse oxygen, self-reported health, and feeds this information to a health professional monitoring this data who responds if necessary to prevent exacerbations. The duration of the intervention is 4 months. The robot sits in the home of the patient - it is not carried around. The frequency of the medication reminders depends on the individual patient but for most p
The intervention is in the form of a robot that reminds people to take medication and do exercises, and measures spirometry, weight, pulse oxygen, self-reported health, and feeds this information to a health professional monitoring this data who responds if necessary to prevent exacerbations. The duration of the intervention is 4 months. The robot sits in the home of the patient - it is not carried around. The frequency of the medication reminders depends on the individual patient but for most patients will be twice daily. The other measures will be daily for the first 3 days and weekly after that. Data from the robot goes to a secure server that can be accessed by the healthcare team. The activity monitors are worn on the wrist to measure exercise. This information is also linked with the robot and the secure server so the healthcare team can monitor adherence to exercise regimes. The smart inhaler data can also be viewed on a secure server by the healthcare team to monitor inhaler use and adherence. In addition, adherence is measured as self-reports both on the robot and by questionnaire at the start and end of the study. The smartphone provides a link between the robot, smartinhaler and the server and allows contact between the patient and the healthcare team.
Sponsors
The business arm of the University of Auckland (Uniservices Ltd)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
16 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria: 1. Confirmed diagnosis of COPD and FEV1<60% predicted 2. COPD main cause of admission 3. Previous admission(s) in past year with COPD 4. Gets out of house <4 times/week (shopping, seeing friends) 5. Living alone (or with spouse but who is also largely housebound) 6. Geographic rural location (>5 km from town) e.g. Awhitu Peninsula, Glenbrook, Maraetai etc. Towns = Waiuku, Pukekohe, Papakura, Howick, 7. Poor social support (visit by friends/family <1/week) and 8. High levels of anxiety on the Clinical COPD Questionnaire (CCQ). (Criteria 1-3 mandatory, minimum of 2 of criteria 4-8 mandatory)
Exclusion criteria
1. Increased BNP or troponin level on admission (predicts increased risk of death in subsequent 6 months) 2. CURB65 score >2 (similar) 3. Life expectancy <1 year 4. Diagnosis of incurable Cancer 5. Comorbid condition causing greater impact on quality of life than COPD e.g. severe CCF, CVA 6. Residence in rest home 7. Living with family/friends 8. Age >90 9. Still working (unless from home).
Outcome results
None listed