Duration: September 2010 - August 2013
Supervision: Prof. dr. H.S.M. Kort, Chair Research Group Demand driven Care
Researcher: S. Vorrink, MSc
Project management: drs S. Barends
Project assistance: M. van den Berg
For patients who suffer from COPD (Chronic Obstructive Pulmonary Disease) a good physical condition is helpful. During rehabilitation patients and physiotherapist try to bring the physical condition to a higher level. After rehabilitation people with COPD receive an activity programme. Unfortunately, the greater part of the patients do not keep to this programme and after a short while they relapse into inactivity. Inactivity itself, however, contributes to a further worsening of the physical condition, and to even more dyspnoea. This results in a vicious circle of inactivity, deconditioning and dyspnoea. Consequently, the results of the rehabilitation are undone. It is therefore important to find or develop an intervention that help people with COPD to maintain or increase their physical activity after a period of rehabilitation, to break this vicious circle and to increase their well-being.
his intervention should also provide the practitioners of various disciplines with a monitor of COPD patients in order to react before exacerbation occurs. When practitioners of COPD patients can foresee health deterioration they can interfere more promptly. In an earlier stage, treatment is less intensive then after an exacerbation. As a result, work pressure for care professionals and medical costs will decrease.
At the moment people with COPD can monitor their own health situation by entering digital questionnaires or filling in a dairy. The practitioner is able to see these data at a distance and assess the necessity of revising the treatment plan. However, this type of remote monitoring is subjective: people tend to overestimate their physical activity. At the same time, evidence suggests that COPD patients do not fill in the questionnaires and dairies as often as is agreed which causes gaps in the data. Therefore, the plan of treatment cannot be revised effectively and in time. As a result, the patient does not receive optimal care. An objective way of monitoring physical activity is advisable, in order to provide patients and practitioners with the right data in an early stage.
The aim of the project `e-Health in COPD care’ is to optimize multidisciplinary COPD care after the rehabilitation period. We try to achieve this by developing an easily accessible and affordable intervention with which COPD patients can measure their physical activity objectively and monitor their physical objectives. Furthermore, the intervention can also provide the professionals involved with information, whereby they are able to monitor at a distance whether a patient keeps to the prescribed exercise programme. Earlier treatment is possible and the care professional can survey the pattern of physical activity of a patient over a longer period. When the physical activity pattern is clear the training programme can be adjusted in order to make it more suitable to the patient.
The project primary concentrates on the care professionals involved, especially on (lung)nurses, pulmonologists and physiotherapists. The profit group of this project are the people with COPD.
1 An inventory of e-Health interventions for the benefit of COPD patients
2 Design of an e-Health application for Smart phones
3 Pilot studies with healthy testers, and subsequently with COPD patients
4 Feasibility studies of the use of the e-Health application by care professionals
5 Adjustment of the E-health application given the results of the pilot studies (step 3)
6 Testing of the e-Health application on effectiveness, validity and reliability
7 Controlled study of ninety COPD patients for nine months
8 Dissemination to research, education and professionals.
The intended result is to optimize the multidisciplinary COPD care in het Utrecht region. This will be achieved by developing a tool in order to maintain the level of physical activity of COPD patients after rehabilitation and to objectify and simplify monitoring the physical activity. The acquired knowledge and the developed intervention will form part of the usual care for COPD patients. The Institute for Nursing Studies, the specialization respiratory Nursing and Advance Nursing Practice and the Institute for Physiotherapy of the Universities of Applied Sciences, the Institute of Nursing Sciences, Physiotherapy Sciences and Kinetic Sciences of the universities, will also benefit from the knowledge generated by this project. This knowledge and experience will give insight into the possible use of e-Health for other target groups with limited mobility.
An e-Health application for a Smartphone which can monitor people with COPD and at the same time can motivate them to be active.
A website for care professionals to be able to read and assess the movement data of the patient in order to give the patient feedback and to intervene if necessary.
The consortium include the following members:
• UU/UMCU, Division Heart and Lung diseases
• COPD Physiotherapy network Utrecht Region
• St. Antonius Hospital, Department of Lung Diseases
• University of Applied Sciences Utrecht, Centre for Innovations in Health Care
The other parties involved are: Catholic University Leuven, Cardiovascular and Respirator Revalidation, Department Pneumology, and Behandelcentrum (Treatment Centre) Heideheuvel in Hilversum. Both organizations have a wide experience with support care and treatment of COPD patients.
Het project E-Health in COPD Care
(registration number: 2010-11-12P)
Is financed by SIA RAAK.