Could Blackberries be key to better health care?

    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 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%. 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 was not easily made secure. The Blackberry approach offers
    the opportunity to achieve high levels of patient commitment and optimise data
    collection and security.