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.