Mobile heath applications for self-management in chronic lung disease: a systematic review.

Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information: The online version contains supplementary material available at 10.1007/s13721-023-00419-0.

Features and characteristics of publicly available mHealth apps for self-management in chronic obstructive pulmonary disease.

Mobile health applications (mHealth apps) may be able to support people living with chronic obstructive pulmonary disease (COPD) to develop the appropriate skills and routines for adequate self-management. Given the wide variety of publicly available mHealth apps, it is important to be aware of their characteristics to optimize their use and mitigate potential harms. Objective: To report the characteristics and features of publicly available apps for COPD self-management. Methods: MHealth apps designed for patients' COPD self-management were searched in the Google Play and Apple app stores. Two reviewers trialed and assessed the eligible apps using the MHealth Index and Navigation Database framework to describe the characteristics, qualities, and features of mHealth apps across five domains. Results: From the Google Play and Apple stores, thirteen apps were identified and eligible for further evaluation. All thirteen apps were available for Android devices, but only seven were available for Apple devices. Most apps were developed by for-profit organizations (8/13), non-profit organizations (2/13), and unknown developers (3/13). Many apps had privacy policies (9/13), but only three apps described their security systems and two mentioned compliance with local health information and data usage laws. Education was the common app feature; additional features were medication reminders, symptom tracking, journaling, and action planning. None provided clinical evidence to support their use. Conclusions: Publicly available COPD apps vary in their designs, features, and overall quality. These apps lack evidence to support their clinical use and cannot be recommended at this time.

Underrepresentation of Respiratory Therapists as Experts in Delphi Studies on Respiratory Practices and Research Priorities.

Delphi survey techniques are a common consensus method used to collect feedback from an expert panel to inform practices, establish guidelines, and identify research priorities. Collecting respiratory therapists' (RT) expertise and experiences as part of consensus-building methodologies is one way to ensure that they align with RT practices and to better influence respiratory care practice. This narrative review aimed to report the RT representation in expert panels of Delphi studies focused on respiratory therapy practices and research priorities. The research question that guided this review is: to what extent are RTs included as expert participants among published Delphi studies relate to respiratory therapy and research topics? We conducted a structured search of the literature and identified 23 papers that reported Delphi studies related to respiratory care practices and 15 that reported on respiratory-related research priorities. Delphi studies that focused on reporting consensus on respiratory care practices included the following: (1) mechanical ventilation, (2) high-flow nasal cannula therapy, (3) COVID-19 respiratory management, (4) home oxygen therapy, (5) cardiopulmonary monitoring, and (6) disease-specific guidelines. Delphi studies that focused on establishing respiratory research priorities included the following: (1) theory and practice-orientated knowledge gaps, and (2) priority research topics for empirical investigation. The results of this review suggest that RTs were rarely included as expert participants and, when involved, were minimally represented (5% to 33%). Given RTs' diverse and relevant experience in respiratory care, incorporating their perspectives to inform future education, respiratory care practices, and research priorities would allow evidence to better align with knowledge gaps deemed important for the respiratory therapy profession.

Rapid access rehabilitation after exacerbations of COPD - A qualitative study.

PURPOSE: Rehabilitation after acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is beneficial, but its feasibility is questionable. Feasibility is potentiated by stakeholder involvement during program development. We aimed to explore the perspectives of various stakeholders towards an innovative rapid access rehabilitation (RAR) program for patients immediately following hospitalization for an AECOPD. METHOD: Semi-structured interviews were conducted with patients recently hospitalized for AECOPD, healthcare professionals (HCP) and policymakers providing care for such patients. Thematic analysis was performed. RESULTS: Three patients (1 female; 62-89 years; GOLD D), ten HCP (3 females, 31-71 years) and three policymakers (3 females, 38-55 years) participated. Patients, HCP and policymakers shared similar visions for the development of a RAR program. Five main themes and ten subthemes were identified. They comprised: Pre-RAR aspects (Management properties, Eligibility), RAR program (Outcomes, Structure, Components), RAR optimization (Referral, Uptake), Partnership (Collaboration, Dedicated Coordinator) and COVID-19 (Adaptations). Essential elements included: identifying clear eligibility criteria, addressing patients' needs at the time of hospital discharge, having a structured education and self-management program and modifying to respond to unexpected events (e.g., COVID). Suggestions to optimize referrals included a clear referral pathway, improving program awareness, assigning dedicated care coordinators to provide patient support throughout the program and establishing strong partnerships among different care settings and providers. CONCLUSIONS: Identifying the essential program elements and approaches to optimize referrals, were considered to be key design approaches for success in establishing RAR.