The efficacy of an interactive questionnaire and a digital clinical decision support system in the clinical monitoring of patients with chronic obstructive pulmonary disease

Objective. To compare the efficacy of various clinical monitoring programs, including a remote monitoring system using automated interactive questionnaire. Materials and methods. The study included 254 patients with COPD, divided into 3 dynamic monitoring groups: the main group of patients (n=77) used a remote monitoring system activities, including an interactive questionnaire; the comparison group (n=75) who used a remote monitoring system activities limited to the assessment of a number of objective parameters: a modified 6-minute walk test (6-MWT test, in steps), daily physical activity (number of steps per day) and peak expiratory flow rate, but the interactive questionnaire was not applied in this group; the control group (n=102), received standard follow-up according to routine clinical practice without remote monitoring in compliance with the Order No. 168n of the Russian Ministry of Health (dated March 15, 2022) “On approval of the Procedure for Dispensary Observation of Adults”. Results. In the main group, where remote monitoring of interactive questionnaire data was combined with the assessment of objective disease criteria, a significant proportion of patient transition from group “E” to group “B” (a course with rare exacerbations) was revealed. In the comparison group, no significant disease rephenotyping was observed. Conversely, in the control group, a significant proportion of patients transitioned from groups “A” and “B” to group “E” (a course with frequent exacerbations). Over the 12 month follow-up period, treatment in the main group was aligned with clinical guidelines; in the comparison group, a less significant redistribution of treatment programs was observed; in the control group, the rate of treatment regimen compliance with clinical guidelines after one year did not exceed 40 %. Conclusions. An approach combining the assessment of subjective (using an interactive questionnaire) and objective criteria for remote monitoring, improves the quality of clinical follow-up in COPD patients, allowing disease rephenotyping, timely detection of disease exacerbations, and achieving symptom control through the prompt adjustment of maintenance therapy, when required.