Chronic diseases are a major burden for patients, the healthcare system and wider society. These conditions are also responsible for unplanned hospital admissions, avoidable morbidity and excess mortality. They negatively impact the quality of life and wellbeing of patients, their families and their communities. Monitoring a patient’s health whilst in the community can improve quality of life and empower them to self-manage their conditions more effectively. This can reduce the burden upon healthcare systems through reducing hospital re-admissions and healthcare interventions.
Our research focuses on a range of conditions and diseases but specifically targets unplanned admissions (and re-admissions) to hospital, which account for an estimated £11bn a year in the UK, by focusing on reducing avoidable morbidity. In 2013, researchers at the Nuffield Department of Primary Care Health Sciences, along with colleagues from the Department of Biomedical Engineering at Oxford University, developed and tested a tablet-based self-management system for chronic obstructive pulmonary disorder (COPD) in the EDGE trial. The trial results showed potential for reduced hospital admissions and better health status for patients that used the EDGE COPD self-management system. Patients reported feeling more confident and more in control of their health. The EDGE2 study builds on the work completed in the EDGE trial with the addition of wearable devices, and aims to recruit a more vulnerable patient cohort by targeting those who have had a recent COPD exacerbation requiring an admission to hospital. Study participants are provided with the self-management system following recruitment in hospital or after hospital discharge. In-patients are able to use the system whilst still in hospital before taking the system home with them following discharge.
Now more than ever, providing vulnerable patients with the information and resources to facilitate self-management of their conditions in their own homes is an important step towards reducing the burden on healthcare and ensuring individuals can maintain their quality of life without exposing them to further risk of infections in the hospital environment. The challenges presented with recent events have caused EDGE2 and its goals to become particularly pertinent to the NHS teams working with these patients. Going forward in a post-pandemic world, EDGE2 will be involving NHS respiratory community teams, allowing them to identify patients who could benefit from self-management support and monitoring using the system. By working closely with our NHS colleagues, we aim to ensure our research will be relevant, practical and beneficial to both healthcare workers and their patients. Developing and evaluating technology that can decrease severe episodes and emergency hospital admissions in people living with COPD has never been more important.