Study: COPD robot improves medication adherence, but no effect on admissions

By Laura Lovett

A socially assistive robot could be key to helping people with COPD manage their condition at home. A recent study published in JMIR, found that COPD patients that had a take-home a robot following a hospitalization were more likely to adhere to their medications and complete their rehabilitation excercises than their peers that did not have a robot. 

In fact, the intervention group had a 48.5 percent adherence rate to inhaler medications, compared to 28.5 percent in the control group. However, researchers did not find a significant difference in the number of respiratory-related hospitalizations between the groups. 

“This pilot study indicates the feasibility and possible effects of giving a robot to COPD patients at home to help manage their condition,” authors of the study wrote. “The primary outcome was number of days in hospital, which was not significantly different. This is consistent with recent large-scale studies on telehealth for COPD showing no reductions in hospitalizations. The study extends research into the delivery of such care to a robot platform. While the robot did not significantly reduce hospitalizations, many patients appeared to appreciate the robot’s capacity to offer companionship, which may offer benefits over other kinds of platforms such as computers or iPads, although this needs to be further investigated.”

Patients with COPD can be treated through medication, and behavioral changes like smoking cessation and exercise, according to the study. However, researchers note that medication adherence in COPD patients is around 50 percent, and good adherence is connected to better education and positive patient-provider relationships. 

Researchers set out to examine how effective a robot delivering telemedicine would be to medication adherence rates and home recovery. The study, which took place in New Zealand, included 60 patients and lasted four months. In order to be included participants had to have been admitted to the hospital within the last year, leave the house less than four times a week, live in a rural location, have poor social support and be between 16 and 90 years old. 

The intervention group were given the iRobot Yujin Robot limited, which was programmed to deliver COPD management. During the trial it gave users a questionnaire where they answered questions about their pulse oximetry, forced expiration volume, heart rate, symptoms, and mental state. It also reminded patients when to take their medication and inhalers, gave them reminders about their rehabilitation exercises, provided education about COPD through videos and pop-up messages and showed health trends over time. 

The robot also had an “I am feeling unwell” button, which patients could press to get linked up with services. If it was an emergency, the robot told the participant to call 911. However, if it was not an emergency and related to their COPD the robot initiated an assessment of pulse oximetry, forced expiration volume and heart rate. This would then be sent to a physiotherapist via a text message. The therapist would call the patient to check in during normal business hours. However, researchers told the patients to continue their usual care treatment outside of business hours. 

Participants in the control group were encouraged to see their primary care physician instead of going to the hospital, unless it was an emergency. They recieved standard care and were referred to physiotherapists and other clinicians when needed. 

In the end three-quarters of participants in the control group reported feeling positive about the robot. 

Researchers said that in the future the robot could be introduced at the hospital and have 24/7 monitoring capabilities. The study also noted that a robot like this could be used to treat other conditions like diabetes and asthma as well. 

“A robot may be useful for COPD patients who are struggling with medication adherence and rehabilitation exercises to improve adherence, although hospitalizations may not be reduced,” authors wrote in the study. “We recommend improvements to the robot, changes to the way it is incorporated into the health care system, and a larger study comparing robots with other forms of technology, before stronger conclusions can be made.”