My Lung Health Coach-A Virtual COPD Self-management Support Program Integrated Into the Electronic Patient Record

Overview

Study Description: My Lung Health Coach (MLHC) is a virtual COPD education and self-management support program delivered through one-on-one sessions with a Certified Respiratory Educator (CRE) over 12 weeks. It includes six sessions that cover essential COPD topics such as: Basic COPD knowledge, Smoking cessation, Medications (inhalers, oxygen), Physical activity, Mental health and wellness, Vaccinations, Symptom self-management, Nutrition, Travel, and Long-term planning (including end-of-life care). The investigators have also developed a companion app to MLHC integrated into the electronic patient record that patients can access through their EPIC MyHealth app on the participants phones, tablets, or desktops. This study will evaluate the feasibility and effectiveness of MLHC and the companion app.

Detailed description

My Lung Health Coach (MLHC) is a freely available evidence-based and person-centered COPD self-management program that connects people virtually with experienced certified respiratory educators (CREs) to provide structured COPD education and self-management support. MLHC was jointly developed by the Lung Health Foundation (a charitable organization focused on lung health advocacy) and academic Respirologist Dr. Andrew Kouri, with input from community members living with COPD. MLHC links community members living with COPD with certified respiratory health educators, using a person-centred approach to provide COPD education and self-management support. It is delivered virtually through one-on-one meetings offered over multiple sessions over 12 weeks. The topics covered in the program include: general COPD knowledge, smoking cessation, COPD medications (inhalers, oxygen), physical activity counselling, mental health and wellness, vaccinations, symptom self-management skills (breathing, energy management, symptom monitoring), nutrition, travel, and long-term planning (including end-of-life care).

To improve the patient experience using MLHC, the investigators have integrated the MLHC program into the Epic Care Companion app at Women's College Hospital, an interactive patient-facing app designed as an extension of the Epic electronic health record system. Using Care Companion, patients will be able to track their progress through MLHC, accomplish session-specific educational and self-management tasks, and share their progress with their Women's College healthcare teams.

Interventions

• Behavioral My Lung Health Coach
  Virtual education and self-management program with companion application

Primary outcome measures

• Feasibility (system use): Number of patients who started program over total offered, over one year. [Time frame: 1 year]
• Feasibility (system use): Number of patients who completed program over total started, over one year. [Time frame: 1 year]
• Feasibility (system use): Number of providers who referred patients to the program over total Number of providers, over approximately one year. [Time frame: 1 year]
• Effectiveness (clinical outcomes): Number of COPD-related outpatient visits [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): Hospital admissions [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): ED visits [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): ICU admissions (at baseline will be over the previous 12 months) [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): COPD severity as measured by the COPD assessment test (CAT) [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): Medication [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]
• Effectiveness (clinical outcomes): Referrals: pulmonary rehab [Time frame: outcomes will be collected prior to program commencement, at program completion (3 month), and at 6-month follow-up.]

Eligibility criteria

Inclusion criteria

• Must be deemed to have capacity to provide informed consent;
• Must sign and date the informed consent form;
• Stated willingness to comply with all study procedures;
• Be diagnosed with COPD as per a WCH Respirologist
• Be 40 years or older
• Be a current or ex-smoker
• Preferred but not required: have a history of at least 1 COPD exacerbation (requiring prednisone or antibiotic use, or an urgent healthcare visit of any kind) in the previous 12 months

Exclusion criteria

• Experienced a COPD exacerbation in the 4 previous weeks to study enrollment
• Co-diagnosis of asthma by a WCH Respirologist
• Significant co-morbidities that could interfere with program participation or terminal illness
• Unwilling to download and use the Epic Care Companion app and has a unsuitable mobile device to do this
• Pregnancy

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Supportive care

Study locations

Canada · 1 center

• Womens College Hospital — Toronto

Identifiers

NCT: NCT07027852 · 1

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗