Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis
BackgroundChronic obstructive pulmonary disease (COPD), marked by dyspnea, cough, and sputum production, significantly impairs patients’ quality of life and functionality. Effective management strategies, particularly those empowering patients to manage their condition, are e...
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JMIR Publications
2025-05-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e76323 |
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| author | Miaoqing Zhuang Intan Idiana Hassan Wan Muhamad Amir W Ahmad Azidah Abdul Kadir Xiaodong Liu Furong Li Yinuo Gao Yang Guan Shuting Song |
| author_facet | Miaoqing Zhuang Intan Idiana Hassan Wan Muhamad Amir W Ahmad Azidah Abdul Kadir Xiaodong Liu Furong Li Yinuo Gao Yang Guan Shuting Song |
| author_sort | Miaoqing Zhuang |
| collection | DOAJ |
| description |
BackgroundChronic obstructive pulmonary disease (COPD), marked by dyspnea, cough, and sputum production, significantly impairs patients’ quality of life and functionality. Effective management strategies, particularly those empowering patients to manage their condition, are essential to reduce this burden and health care use. Digital health interventions—such as mobile apps for symptom tracking, wearable sensors for vital sign monitoring, and web-based pulmonary rehabilitation programs—can enhance self-efficacy and promote greater patient engagement. By improving self-management skills, these interventions also help alleviate pressure on health care systems.
ObjectiveThis systematic review and meta-analysis assesses the clinical effectiveness of smartphone apps, wearable monitors, and web-delivered platforms in four COPD management areas: (1) quality of life (measured by the COPD Assessment Test [CAT] and St George’s Respiratory Questionnaire), (2) self-efficacy (assessed by the General Self-Efficacy Scale), (3) functional capacity (evaluated via the 6-minute walk test and Modified Medical Research Council Dyspnea Scale), and (4) health care use (indicated by hospital and emergency department visits).
MethodsA systematic review was conducted using predefined search terms in PubMed, Embase, Cochrane, and Web of Science up to January 26, 2025, to identify randomized trials on digital health interventions for COPD. Two reviewers independently screened studies and extracted data. Outcomes included quality of life, self-efficacy, functional status, and health care use.
ResultsThis review included 17 studies with 2027 participants from 11 countries. Eleven trials involved health care professionals in digital platform use, and 12 reported adherence strategies. Digital tools for COPD primarily focused on telerehabilitation (eg, video-guided exercises) and self-management systems (eg, artificial intelligence–driven exacerbation alerts). The study participants were predominantly older adults. Meta-analysis results indicated that digital health interventions significantly improved quality of life at 3 months on the CAT (mean difference [MD] −1.65, 95% CI –3.17 to –0.14; P=.03); at 6 months on the CAT (MD −2.43, 95% CI −3.93 to −0.94; P=.001) and St George’s Respiratory Questionnaire (MD 3.25, 95% CI 0.69-5.81; P=.01); at 12 months on the CAT (MD −2.53, 95% CI −3.91 to −1.16; P<.001), EQ-5D (MD 0.04, 95% CI 0.01-0.07; P=.02), and EQ-5D visual analogue scale (MD 5.88, 95% CI 0.38-11.37; P=.04); the General Self-Efficacy Scale at 3 months (MD 1.65, 95% CI 0.62-2.69; P=.002) and 6 months (MD 1.94, 95% CI 0.83-3.05; P<.001); and the Modified Medical Research Council Dyspnea Scale at more than 3 months (MD −0.23, 95% CI −0.36 to −0.11; P=.003). However, no significant differences were observed in the 6-minute walk test, emergency department admissions, hospital admissions, emergency department admissions for COPD, or hospital admissions for COPD.
ConclusionsOur findings suggest that digital health interventions may benefit COPD patients, but their clinical effectiveness remains uncertain. Further robust studies are needed, particularly those involving larger numbers of older adults with COPD.
Trial RegistrationPROSPERO CRD420251032053; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251032053 |
| format | Article |
| id | doaj-art-617e034b2c8248a28d10ec67b6720aca |
| institution | OA Journals |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-617e034b2c8248a28d10ec67b6720aca2025-08-20T02:29:30ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-05-0127e7632310.2196/76323Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-AnalysisMiaoqing Zhuanghttps://orcid.org/0009-0003-3801-191XIntan Idiana Hassanhttps://orcid.org/0000-0001-6907-8920Wan Muhamad Amir W Ahmadhttps://orcid.org/0000-0003-2366-3918Azidah Abdul Kadirhttps://orcid.org/0000-0003-1039-6304Xiaodong Liuhttps://orcid.org/0009-0003-0770-5409Furong Lihttps://orcid.org/0009-0003-6739-1288Yinuo Gaohttps://orcid.org/0009-0000-0625-7075Yang Guanhttps://orcid.org/0009-0004-7895-272XShuting Songhttps://orcid.org/0009-0001-6973-872X BackgroundChronic obstructive pulmonary disease (COPD), marked by dyspnea, cough, and sputum production, significantly impairs patients’ quality of life and functionality. Effective management strategies, particularly those empowering patients to manage their condition, are essential to reduce this burden and health care use. Digital health interventions—such as mobile apps for symptom tracking, wearable sensors for vital sign monitoring, and web-based pulmonary rehabilitation programs—can enhance self-efficacy and promote greater patient engagement. By improving self-management skills, these interventions also help alleviate pressure on health care systems. ObjectiveThis systematic review and meta-analysis assesses the clinical effectiveness of smartphone apps, wearable monitors, and web-delivered platforms in four COPD management areas: (1) quality of life (measured by the COPD Assessment Test [CAT] and St George’s Respiratory Questionnaire), (2) self-efficacy (assessed by the General Self-Efficacy Scale), (3) functional capacity (evaluated via the 6-minute walk test and Modified Medical Research Council Dyspnea Scale), and (4) health care use (indicated by hospital and emergency department visits). MethodsA systematic review was conducted using predefined search terms in PubMed, Embase, Cochrane, and Web of Science up to January 26, 2025, to identify randomized trials on digital health interventions for COPD. Two reviewers independently screened studies and extracted data. Outcomes included quality of life, self-efficacy, functional status, and health care use. ResultsThis review included 17 studies with 2027 participants from 11 countries. Eleven trials involved health care professionals in digital platform use, and 12 reported adherence strategies. Digital tools for COPD primarily focused on telerehabilitation (eg, video-guided exercises) and self-management systems (eg, artificial intelligence–driven exacerbation alerts). The study participants were predominantly older adults. Meta-analysis results indicated that digital health interventions significantly improved quality of life at 3 months on the CAT (mean difference [MD] −1.65, 95% CI –3.17 to –0.14; P=.03); at 6 months on the CAT (MD −2.43, 95% CI −3.93 to −0.94; P=.001) and St George’s Respiratory Questionnaire (MD 3.25, 95% CI 0.69-5.81; P=.01); at 12 months on the CAT (MD −2.53, 95% CI −3.91 to −1.16; P<.001), EQ-5D (MD 0.04, 95% CI 0.01-0.07; P=.02), and EQ-5D visual analogue scale (MD 5.88, 95% CI 0.38-11.37; P=.04); the General Self-Efficacy Scale at 3 months (MD 1.65, 95% CI 0.62-2.69; P=.002) and 6 months (MD 1.94, 95% CI 0.83-3.05; P<.001); and the Modified Medical Research Council Dyspnea Scale at more than 3 months (MD −0.23, 95% CI −0.36 to −0.11; P=.003). However, no significant differences were observed in the 6-minute walk test, emergency department admissions, hospital admissions, emergency department admissions for COPD, or hospital admissions for COPD. ConclusionsOur findings suggest that digital health interventions may benefit COPD patients, but their clinical effectiveness remains uncertain. Further robust studies are needed, particularly those involving larger numbers of older adults with COPD. Trial RegistrationPROSPERO CRD420251032053; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251032053https://www.jmir.org/2025/1/e76323 |
| spellingShingle | Miaoqing Zhuang Intan Idiana Hassan Wan Muhamad Amir W Ahmad Azidah Abdul Kadir Xiaodong Liu Furong Li Yinuo Gao Yang Guan Shuting Song Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis Journal of Medical Internet Research |
| title | Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis |
| title_full | Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis |
| title_fullStr | Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis |
| title_short | Effectiveness of Digital Health Interventions for Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis |
| title_sort | effectiveness of digital health interventions for chronic obstructive pulmonary disease systematic review and meta analysis |
| url | https://www.jmir.org/2025/1/e76323 |
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