Predict&Prevent: Use of a Personalised Early Warning Decision Support System to Predict and Prevent Acute Exacerbations of COPD

COPD is a common complex disease with debilitating breathlessness; mortality and reduced quality of life, accelerated by frequent lung attacks (exacerbations). Changes in breathlessness, cough and/or sputum production often change before exacerbations but patients cannot judge the importance of such changes so they remain unreported and untreated. Remote monitoring systems have been developed but none have yet convincingly shown the ability to identify these early changes of an exacerbation and how severe they can be. This study asks if a smart digital health intervention (COPDPredict™) can be used by both COPD patients and clinicians to improve self-management, predict lung attacks early, intervene promptly, and avoid hospitalisation. COPDPredict™ consists of a patient-facing App and clinician-facing smart early warning decision support system. It collects and processes information to determine a patient's health through a combination of wellbeing scores, lung function and biomarker measurements. This information is combined to generate personalised lung health profiles. As each patient is monitored over time, the system detects changes from an individual's 'usual health' and indicates the likelihood of imminent exacerbation of COPD. When this happens, alerts are sent to both the individual and the clinician, with instructions to the patient on what actions to take. Any advice from clinicians can be exchanged via the App's secure messaging facility. If patients have followed the action plan but fail to improve or if an episode triggers an 'at high risk alert', clinicians are further prompted to case manage and intervene with escalated treatment, including home visits, if necessary. The COPDPredict™ intervention aims to assist patients and clinicians in preventing clinical deterioration from COPD exacerbations with prompt appropriate intervention. This study will randomise 384 patients who have frequent exacerbations, from hospitals in the West Midlands, to eith