Mobile health (mHealth)-supported community management of COPD

Background Chronic obstructive pulmonary disease (COPD) remains a major public health challenge in China, with high prevalence and suboptimal rates of standardized long-term management. Conventional community-based management models are often limited by poor continuity and accessibility. Mobile health (mHealth) technologies offer a promising approach to enhance chronic disease management. This study aimed to evaluate the feasibility and real-world effectiveness of an mHealth-supported COPD management system in improving clinical outcomes and reducing exacerbations. Methods An mHealth-based COPD management platform integrated into the WeChat ecosystem was developed in accordance with the 2022 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Between May 2022 and April 2023, 260 patients with COPD were prospectively enrolled from Beilun People’s Hospital in Ningbo, China. Patients received either mHealth-supported management (including electronic health record integration and regular remote guidance from healthcare providers) or usual care with routine discharge follow-up. The intervention duration was 12 months. Clinical outcomes, including pulmonary function parameters (FEV1, FEV1% predicted, FEF50, FEF75, MMEF), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and frequency of acute exacerbations, were compared between groups. All analyses were conducted under a modified intention-to-treat framework using the last observation carried forward (LOCF) method to account for missing data. Results After 12 months, patients receiving mHealth-supported management demonstrated significant improvements in symptom burden and dyspnea, with CAT scores decreasing from 21.80 ± 3.24 to 17.30 ± 4.04 and mMRC scores from 2.43 ± 0.69 to 1.82 ± 0.75 (both p < 0.001). No significant overall improvement in FEV1 or FEV1% predicted was observed within groups, although between-group differences emerged at later time points. However, parameters reflecting small airway function improved significantly in the mHealth group, including FEF50, FEF75, and MMEF (all p < 0.001), whereas these measures declined in the usual care group. The annual frequency of acute exacerbations was significantly lower in the mHealth group (1.67 ± 0.80 vs. 2.24 ± 0.45, p < 0.001). In addition, the mHealth-based early warning system was associated with earlier healthcare utilization (mean reduction of 2.31 days), shorter hospital stays, and reduced medical costs. Conclusion mHealth-supported COPD management was associated with improved symptoms, reduced dyspnea, enhanced small airway function, and fewer acute exacerbations in a real-world setting. Given the non-randomized design, these findings should be interpreted as reflecting associations rather than definitive causal effects. This approach may offer a practical strategy for improving long-term disease management and reducing healthcare burden in community-based COPD care

COPD · Disease management · Exacerbation · Health care · Medical record · Prospective cohort study · Public health · Pulmonary disease · Chronic Obstructive Pulmonary Disease (COPD) Research · Delphi Technique in Research · Mobile Health and mHealth Applications

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