Can a health forecasting service offer COPD patients a novel way to manage their condition?

Objectives: The UK Meteorological Office (Met Office) has developed a health forecasting service for chronic obstructive pulmonary disease (COPD) patients, combining a rule-based model predicting risk based on environmental conditions with an anticipatory care intervention providing information on self-management and warnings via an interactive telephone call. Our aim was to explore the acceptability and utility of such a service to patients with COPD and its perceived impact on their behaviour and disease management. Methods: A cross-sectional questionnaire survey of service users drawn from 189 general practices in England, Scotland and Wales at the end of the winter of 2007/8. Results: Completed questionnaires were received from 3288 COPD patients, representing a response rate of 40%. Eighty-five percent of those returning a questionnaire reported at least one exacerbation during the study period and 8% had been admitted to hospital on one occasion or more. The majority of respondents deemed the information pack (comprising a booklet and thermometers) useful while the automated calls were generally said to be convenient, easy to understand and reassuring. Those less satisfied with the service felt they were already sufficiently aware of the prevailing weather conditions or felt more detailed information was needed. Most benefit was reported by those patients who were willing to be pro-active in the management of their condition, with the service encouraging 36% of respondents to seek a repeat prescription, 28% to reread their information pack and 12% to consult their GP for worsening of symptoms. Conclusions: Patients found the automated interactive calling, combined with a health risk forecast, both viable and useful, welcoming the information and tools it offered. In many cases, it added to patients’ understanding of their illness and promoted better self-management. Future research should focus on the potential impact of the service in terms of health outcomes and cost-effectiveness.

[1]  E. Walters,et al.  Self-management education for patients with chronic obstructive pulmonary disease. , 2007, The Cochrane database of systematic reviews.

[2]  T. Seemungal,et al.  Effect of temperature on lung function and symptoms in chronic obstructive pulmonary disease. , 1999, The European respiratory journal.

[3]  F. Maltais,et al.  Self-management reduces both short- and long-term hospitalisation in COPD , 2005, European Respiratory Journal.

[4]  Mamie LaVigne,et al.  Interactive Voice Response in Disease Management , 1998 .

[5]  Mike Thomas,et al.  COPD management in the community: early detection and proactive care. , 2005, Primary care respiratory journal : journal of the General Practice Airways Group.

[6]  D. Forman,et al.  Delays in managing lung cancer. , 2004, Thorax.

[7]  J. Cleland,et al.  Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis , 2007, BMJ : British Medical Journal.

[8]  H. Vrijhoef,et al.  Identifying potentially cost effective chronic care programs for people with COPD , 2008, International journal of chronic obstructive pulmonary disease.

[9]  Michael Kirshner,et al.  Use and impact of an automated telephone outreach system for asthma in a managed care setting. , 2006, The American journal of managed care.

[10]  P. Camp,et al.  Gender and the diagnosis, management, and surveillance of chronic obstructive pulmonary disease. , 2007, Proceedings of the American Thoracic Society.

[11]  C. Salisbury,et al.  Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction , 2007, Emergency Medicine Journal.

[12]  D. Niewoehner,et al.  Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease in the Elderly , 2007, Drugs & aging.

[13]  J. Bourbeau,et al.  Self-management and behaviour modification in COPD . , 2004, Patient education and counseling.

[14]  G. Donaldson,et al.  COPD exacerbations · 1: Epidemiology , 2006, Thorax.