NICE has recommended two digital platforms for pulmonary rehabilitation which could improve provision for chronic obstructive pulmonary disease patients who are unable to access face-to-face services.
Draft guidance greenlit an app and an online platform for use in the NHS while more evidence is gathered.
The technologies offer exercise programmes and education sessions to help people with COPD manage their condition at a time and place that suits them.
Currently, GPs refer patients to community or hospital COPD services for face-to-face rehabilitation and these referrals are measured in the QOF for patients with a score of three or more on the Medical Research Council (MRC) dyspnoea scale.
However, the NHS long term plan revealed that face-to-face programmes are only offered to 13% of eligible patients, particularly focussing on those with more severe COPD.
NICE has therefore said that the two platforms – myCOPD and SPACE for COPD – could be suitable for patients who do not have easy access to face-to-face services or who would prefer not to be treated in person.
This technology should complement rather than replace the current service provision, NICE highlighted.
Interim director of NICE’s health technologies programme Mark Chapman said: ‘There is a huge unmet need for access to pulmonary rehabilitation programmes by people with COPD.
‘Our committee hopes by recommending two digital technologies which provide these programmes they could help people living in areas without access to an in-person service to receive the vital care they need.’
NICE has said there are ‘no safety concerns’ with the digital platforms, and that clinical evidence suggests they may improve exercise capacity and symptoms of COPD while potentially costing the NHS less money than face-to-face sessions.
The technologies
myCOPD
myCOPD (my mhealth Ltd) is an online education, self-management, symptom reporting and pulmonary rehabilitation system. The myCOPD app includes a 6-week pulmonary rehabilitation course. This consists of an incremental exercise programme with education sessions to help with self-management of COPD. The app also has a dashboard of self-care tools and educational resources for people with all stages of COPD. The app can be accessed with a mobile phone or tablet.
SPACE for COPD
SPACE for COPD (University Hospitals of Leicester NHS Trust) is a digital self-management programme designed to help people with COPD manage their condition more effectively. The programme contains educational topics including information about medicine, breathing control, exercise and nutritional advice. Users are encouraged to set goals, progress through a prescribed exercise programme and achieve weekly targets. The technology can be accessed with a mobile phone, tablet or desktop computer.
Source: NICE
A consultation on the draft guidance will run until Wednesday (10 January).
Earlier this year, a leading charity called for primary care to be properly funded to do spirometry after figures showed plummeting rates of COPD diagnoses.
Asthma+Lung UK raised concerns about patchy provision of respiratory diagnostic tests, highlighting that diagnoses fell by 51% in 2022 compared with pre-pandemic figures.
And in September, the charity claimed that an ongoing lack of spirometry and FeNO testing – despite clear recommendations from NICE – was costing £2.2bn in avoidable hospital stays and treatment.
