Using an eDiary and wrist-band accelerometer to detect exacerbations and activity levels in COPD: a feasibility study

Background: Early and accurate identification of acute exacerbations of chronic obstructive pulmonary disease may lead to earlier treatment and prevent hospital admission. Electronic diaries have been developed for symptom monitoring and accelerometers to monitor activity. However, it is unclear whether this technology is usable in the COPD population. Aims: This study aimed to assess the feasibility of an electronic diary (eDiary) for symptom reporting using the MoRe care App and activity monitoring with the Garmin Vivofit 2 in COPD. Methods: Participants were recruited from the London COPD cohort. Participants were provided a Garmin Vivofit 2 activity monitor and an android tablet with the MoreCare App for a period of 3 months. Results Twenty-five COPD patients were recruited. Mean age 70.8 +/- 7.1 years FEV1 49.8 +/- 14.8% predicted. Age, gender, disease severity and exacerbation frequency had no impact on eDiary compliance. There was a moderate positive correlation between median daily very active minutes and FEV1 %predicted (rho = 0.62, p = 0.005). Daily step counts decreased during the initial 7 days of exacerbation and recovery compared to a pre-exacerbation baseline. A decision tree model identified change in sputum colour, change in step count, severity of cold, exacerbation history, and use of rescue medication as the most important predictors of AECOPD in this cohort. Conclusions: Symptom and activity monitoring using digital technology is feasible in COPD. Further large-scale digital health studies are needed to assess if eDiaries can be used to identify patients at risk of exacerbation and guide early intervention