Imperial College London
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MrJackElkes

Faculty of Medicine, School of Public Health

NIHR Doctoral Fellow
 
 
 
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Contact

 

+44 (0)20 7594 1747j.elkes Website

 
 
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Location

 

Stadium HouseWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Crooks:2020:10.1183/23120541.00460-2020,
author = {Crooks, M and Elkes, J and Storrar, W and Roy, K and North, M and Blythin, A and Watson, A and Cornelius, V and Wilkinson, T},
doi = {10.1183/23120541.00460-2020},
journal = {ERJ Open Research},
pages = {1--10},
title = {Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial},
url = {http://dx.doi.org/10.1183/23120541.00460-2020},
volume = {6},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Self-management interventions in COPD aim to improve patients’ knowledge, skills and confidence to make  correct  decisions,  thus  improving  health  status  and  outcomes.  myCOPD  is  a  web-based  self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD. We explored its impact in patients with mild-moderate or recently diagnosed COPD through a 12-week, 34open-label, parallel-group, randomised-controlled trial of myCOPD compared with usual care.  The co-primary  outcomes  were  between  group  differences  in  mean  COPD  assessment  test  (CAT)  score  at  90 days  and  critical  inhaler  errors.  Key  secondary  outcomes  were  app  usage  and  patient  activation measurement (PAM) score. 3860 patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for FEV1% predicted but  baseline  imbalance  between  groups  for  exacerbation  frequency  and  CAT  score.  There  was  no significant  adjusted  mean  difference  in  CAT  score  at  study  completion,  -1.27  (95%  CI  -4.47  to  1.92, p=0.44) lower in COPD. However increasing app use associated with greater CAT score improvement. The odds of ≥1 critical inhaler error was lower in the myCOPD arm (adjusted odds ratio of 0.30 (0.09; 431.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (0.46; 5.85) in favour of myCOPD. The  small  sample  size  and  phenotypic  difference  between  groups  limited  our  ability  to  demonstrate statistically  significant  evidence  of  benefit  beyond  inhaler  technique.  However,  our  findings  provide important  insights  into  associations  between  increased  app  use  and  clinically  meaningful  benefit 48warranting further study in real world settings.
AU  - Crooks,M
AU  - Elkes,J
AU  - Storrar,W
AU  - Roy,K
AU  - North,M
AU  - Blythin,A
AU  - Watson,A
AU  - Cornelius,V
AU  - Wilkinson,T
DO  - 10.1183/23120541.00460-2020
EP  - 10
PY  - 2020///
SN  - 2312-0541
SP  - 1
TI  - Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial
T2  - ERJ Open Research
UR  - http://dx.doi.org/10.1183/23120541.00460-2020
UR  - https://openres.ersjournals.com/content/6/4/00460-2020
UR  - http://hdl.handle.net/10044/1/82324
VL  - 6
ER  -
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