Evaluation of an integrated digital and mobile intervention to improve outcomes for patients with moderate to severe COPD

Chronic obstructive pulmonary disease (COPD) leads to high rates of emergency department (ED) visits and hospitalizations. This study evaluated a community-based digital health intervention's association with acute care utilization among patients with moderate to severe COPD. In a decentralized, nonrandomized trial, participants received biometric monitoring, symptom tracking, on-demand paramedic services, and digital pulmonary rehabilitation for 6 months. Outcomes were compared to a synthetic control group using weighted optimal matching and multivariable-adjusted regression. The primary outcome was hospitalization; secondary outcomes included readmission rates, ED visits, length of stay, and mortality. Eighty-eight intervention participants (mean age 67 (SD 10)) were compared to a weighted control group of 14,492 (mean age 69 (SD 11)). Intervention participants had lower odds of hospitalization (OR 0.67, 95% CI: 0.46-0.98) and 30-day readmission (OR 0.38, 95% CI: 0.17-0.84). This digital and mobile intervention was associated with reduced acute care use and supports further evaluation of hybrid care models for COPD.