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Chronic care

BlackBerry used to help manage COPD patients

HAMILTON, Ont. – Wireless handhelds are revolutionizing almost every aspect of life these days. Now, a team of health scientists has launched a new study on how BlackBerries might be used to improve the monitoring and treatment of patients suffering from chronic disease – and even to save lives.

Led by Neil Johnston of the Firestone Institute for Respiratory Health at St. Joseph’s Healthcare in Hamilton, the study will use specially configured Blackberries to help monitor 120 patients living at home and suffering from Chronic Obstructive Pulmonary Disease (COPD).

The study has two objectives: first to establish that the BlackBerry-based reporting system, or diary, will work for this monitoring purpose, and secondly, to determine the factors that cause exacerbations of COPD throughout yearly cycles of the disease.

Patients in the study will record their symptoms daily on their BlackBerry and transmit the information to study nurses for review. If a patient experiences symptoms that suggest that an exacerbation is occurring, a team member will go to the patient’s home to assess the situation.

Early detection is important because the symptoms associated with a medical crisis often begin up to seven days prior to the peak. If treatment can be administered early, there is potential to reduce the severity and duration of the crisis, and as a result, reduce the need for emergency treatment in hospital.

“We want to see whether this technology can be used to improve the early detection of serious complications in COPD patients so that health professionals can intervene in a more timely manner,” said Dr. Johnston, who is an epidemiologist and Assistant Professor of Medicine at McMaster University.

“We also are hoping to pinpoint with more precision the high-risk peak periods of the year,” he said. Johnston said there are signs that the period between Christmas and New Year’s is a particularly risky period for COPD patients. Festive and family events, stress and different eating patterns may all have an impact on the severity of symptoms, he said but little is currently known about the causes of the Christmas epidemics of COPD.

COPD refers to two lung problems – chronic bronchitis and emphysema – often present in the same patient. The diseases interfere with normal breathing and are often associated with other medical problems such as heart disease and diabetes. The American Lung Association ranks COPD as the fourth leading cause of death in the US, claiming the lives of more than 120,000 people a year.

Johnston and his research colleague, Andy McIvor, a Professor of Medicine at McMaster, have teamed up with scientists from Imperial College, London, and AstraZeneca Pharmaceuticals in the UK and Sweden to carry out the study. AstraZeneca is funding the work through a research grant.

“BlackBerries have the potential to revolutionize daily monitoring,” Johnston said. The devices are wireless and can be used no matter where the patient is. They can be configured to enter data using the track wheel only, which is an advantage for some elderly patients and those suffering from arthritis. Another advantage is that the data can be transmitted securely and patient monitoring can be done on a daily basis without patients having to leave their homes or disrupt their schedules and lives.

Effective monitoring of symptoms is an essential part of caring for people with COPD. Symptoms such as worsening breathlessness, coughing and chest tightness are associated with an increased risk of death.

Last winter, Johnston led a study of 70 COPD patients using faxed daily diary sheets from subjects’ homes to capture and review symptoms on a daily basis. In this pilot study, compliance exceeded 90 percent. However, fax-based diaries proved to be cumbersome, restricted the amount of information collected and only worked when patients were at their homes.

Furthermore, data transmitted by fax were not easily made secure. The BlackBerry approach offers the opportunity to achieve high levels of patient commitment and optimize data collection and security.