M-ACZiE: Mobile action plan to enhance self-management and early detection of exacerbations in patients with COPD

Duration: This PhD study will last from October 2014 until October 2018.

This PhD study belongs to the TASTE project of the research group Chronic Illnesses at HU University of Applied Sciences and the chair of Nursing Science at Utrecht University.

Social relevance and relevance for education

COPD is one of the most common chronic diseases and the fourth leading cause of mortality worldwide. The prevalence of COPD patients is expected to increase in the common decades leading to increased healthcare costs. The natural course of COPD is interrupted by periods of significant symptom deterioration which is called an exacerbation. Exacerbations have a negative impact on quality of life, are associated with accelerated lung function decline and increase the risk of hospitalization and mortality.

Early detection of an exacerbation and taking prompt actions are important to reduce the impact of an exacerbation. However, detection of fluctuations in symptoms appears to be difficult for patients and results in inadequate reactions. Previous research has shown that supporting patients in early detection of an exacerbation and teaching self-management skills by an action plan contributes to acceleration of recovery time and reduces the acute impact of exacerbations on health status. However, no effects on health related quality of life and health care utilization were observed. A more dynamic intervention is expected to be more responsive to heterogeneity in COPD patients and exacerbations and may therefore be more effective on quality of life and health care utilization.

Mobile technology (mHealth) creates possibilities to add several essential and tailored elements on regular care and may be a solution. The aim of the TASTE research group is to reduce the impact of an exacerbation and improve quality of life by a mHealth intervention. It is important that the intended mHealth intervention meets patients perceptions, capabilities and needs.

This PhD study will focus on the development and evaluation of a mHealth intervention to improve self-management and early detection of exacerbations in patients with COPD. The mHealth intervention will be developed in a user-centered development design in which patients, health care professionals and mHealth experts will collaborate to guarantee effectiveness and safety.

The results of this research will be translated to practice by implementing the mHealth intervention. In addition the results of this research will reach nursing practice through education in the bachelor of Nursing. Bachelor students of Nursing, master students of Nursing Science and other master students are able to participate in this research for their thesis.

Objective

User-centered development and evaluation of a tailored mHealh intervention to improve self-management and early detection of exacerbation in patients with COPD. More specific a mHealth intervention that is

  • Safe and patient friendly.
  • Meets patient’s needs, perceptions and preferences.
  • Able to manage heterogeneity in exacerbations in/between patients.

Implementation

The acquired knowledge will be disseminated by publications in scientific journals and through education at the faculty of healthcare at HU University of Applies Sciences. In case of proven effectiveness the developed mHealth intervention will be implemented.

Collaboration

For M-ACZiE there is a collaboration with the department of Revalidation, Nursing Science and Sport at the University Medical Center of Utrecht. In addition several healthcare institutions will be approached for collaboration in the development and evaluation of M-ACZiE.

Promotors

  • First promotor: prof. dr. M.J. Schuurmans, Utrecht University.
  • First copromotor: dr. J.C.A. Trappenburg, Utrecht University.

Finance

This PhD study is financed by HU Utrecht University of Applied Sciences and University Medical Center of Utrecht.

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