Early-stage feasibility of the "Copilot for COPD" app in Healthcare providers' daily practice: a qualitative study

Abstract

Background: Improved exacerbation outcomes are found in COPD patients who recognize exacerbations early on and perform prompt and adequate actions. The recently developed 'Copilot for COPD' application is designed to increase these key self-management skills by early detection of symptom deterioration through self-monitoring, and performing adequate and prompt action through individualized action planning. Health care providers’ (HCP) role is to install, personalize and evaluate the app with patients. Evaluating HCPs’ perceptions regarding feasibility of the app within constraints of daily practice is important and will determine if the app is suitable for pilot testing with HCPs and patients. Purpose: To evaluate the perceived feasibility of the Copilot app in HCPs’ daily practice regarding acceptability, demand, implementation, practicality and integration Methods: Qualitative study using observations, think aloud, semi-structured interviews with HCPs with a case-management role in COPD care (n=13), conducted in primary-, secondary- and tertiary health care settings in the Netherlands from February 2019 to June 2019. Data were analysed by thematic analysis. Results: HCPs found the app acceptable and expressed interest to use the app. Perceived benefits included a enhancing self-management behavior; structure patient-HCP contact; provide direction in treatment; improve uniformity in exacerbation self-management support; and be used throughout and across healthcare settings. Potential risks included increased treatment burden and substituting HCP contact with app. Individual patient characteristics and fit with workflow and time were considered facilitators and or barriers. Conditions to be met included management support, training and instructions, WIFI, and app integration with local IT systems. Integrating the app into current care paths across settings was perceived feasible, considered a shared responsibility, and fits nurses role best. Finally, several usability problems were found. Conclusions: Important conditions need to be met and usability issues resolved before further feasibility testing can be evaluated.