IAANMP: Advanced practice journal article review

A smartphone app self-management programme for chronic obstructive pulmonary disease: Randomised controlled trial of clinical outcomes

Authors: Glynn L, Moloney E, Lane S, McNally E, Buckley C, McCann M, McCabe C.
Reference: Glynn L, Moloney E, Lane S, McNally E, Buckley C, McCann M, McCabe C.

A smartphone app self-management programme for chronic obstructive pulmonary disease: Randomised controlled trial of clinical outcomes. JMIR Mhealth Uhealth. 2025;13: e56318. doi: 10.2196/56318. PMID: 40267465; PMCID:
PMC12059498.
Published Date: 23 April 2025. Published in JMIR mHealth and uHealth, Volume 13, Article e56318, April 2025.
Journal article review written by: Donaliza Cromar, RANP (Emergency Care), MSc (Advanced Nursing Practice), RNP, PGDip (Emergency Care), BSc (General Nursing), RGN.

Introduction and study rationale
In their abstract, Glynn et al (2025) highlight that chronic obstructive pulmonary disease (COPD) has a detrimental impact on health, contributing to frequent exacerbations, increased hospitalisations, reduced physical activity, poorer quality of life, and diminished self-efficacy. They note that prior research indicates tailored self-management programmes for adults with COPD can support better decision-making and improve clinical outcomes.

However, earlier studies have been limited by heterogeneous interventions, varied patient populations, inconsistent outcome measures, and insufficient long-term follow-up. The authors point out a key research gap, as few investigations have evaluated the effects of a comprehensive, smartphone-based self-management programme for adults with COPD over a full 12-month period.

In 2025, Lisa Glynn led a pilot randomised controlled trial in Ireland investigating how a smartphone-based self-management programme could affect people with COPD. The study compared three approaches: The smartphone programme alone, the smartphone programme combined with monthly phone calls, and standard outpatient care, assessing their impact on clinical outcomes in adults with COPD.

Methods
The authors acknowledged that as the concept of this trial was the first of its kind in Ireland, it was important to assess its feasibility; therefore, a single-center pilot randomised controlled trial was conducted in Ireland at Tallaght University Hospital /Trinity College Dublin, enrolling 92 participants who were evenly distributed across three parallel groups. Designed as a feasibility study for a future larger multicentre trial, the groups were:

1. Intervention Arm 1: Self-management app plus monthly support phone calls from a healthcare professional aimed at promoting app use and reinforcing self-care behaviours (n=31).

2. Intervention Arm 2: Self-management app only (n=31). The self-management smartphone app included:

• Symptom tracking (breathlessness via mMRC scale), step counts, lung function (FEV₁), SpO^₂ using Bluetooth-enabled spirometer and pulse oximeter;
• Monthly educational videos (two per month over 12 months);
• Motivational in-app messages twice weekly;
• Communication channel with healthcare professionals and technical support via the company patientMpower.

3. Control Arm 3: Standard respiratory outpatient care (n=30).

Glynn et al took appropriate measures to ensure study quality, using the CONSORT (Consolidated Standards of Reporting Trials) checklist to guide its design, analysis, and reporting.

Findings
Over a six to 12-month period, both app groups regardless of call support experienced significantly fewer COPD flare-ups requiring GP or hospital visits compared to controls (GP visits: P=.01, hospital visits: P=.006 at six months).

Arm 1 participants also showed notable improvements in exercise capacity at both six and 12 months (P=.02 and P=.03), while arm 2 recorded significantly higher daily step counts than the control group (P=.009). Engagement levels were strong, with 60 per cent of app users (33 of 55) continuing to use the tool over the full year.

Overall, the findings indicate that a smartphone self-management programme can meaningfully reduce COPD exacerbations and boost physical activity and exercise tolerance, making it a promising option particularly in areas where access to conventional pulmonary rehabilitation is limited.

Critical evaluation: Strengths and limitations
The positive outcomes observed in this study highlight the potential of smartphone applications in managing chronic diseases. By providing patients with tools for self-monitoring and education, such interventions can empower individuals to take an active role in their health management.

The reduction in exacerbations and hospitalisations suggests that such digital tools may alleviate the burden on healthcare systems.

However, the study’s limitations, including its single-centre design and small sample size, suggest future research should aim to replicate these findings in larger, multicentre trials to confirm the app’s efficacy and explore its applicability across diverse populations.

Conclusion
Glynn et al’s (2025) study contributes valuable insights into the role of smartphone applications in chronic disease management. While the results are promising, further research is needed to validate these findings and determine the long-term impact of digital health interventions on patient outcomes in COPD.

Authors