Effectiveness of mHealth applications and patient-reported outcomes measures for COPD management in older adults: Systematic review and meta-analysis
Xiayu Summer Chen, Renato Ferreira Leitao Azevedo, Michael Varzino, Nidhi Patel, Wendy A. RogersObjective
Chronic obstructive pulmonary disease (COPD) disproportionately affects older adults, and mobile health (mHealth) applications represent a promising but underexplored approach to support self-management and improve health outcomes in this population. The objective of this review was to identify randomized controlled trials (RCTs) on COPD-specific mHealth applications and synthesize evidence regarding the clinical, behavioral, and implementation outcomes for older adults.
Methods
Three rounds of extensive search of 12 databases and backward citations yielded 2,590 papers after deduplication. After screening, 9 RCTs met the inclusion criteria. The interventions included pulmonary rehabilitation, exercise training, tablet-based video instruction, monitoring systems, and medication-management applications. Meta-analyses were conducted only for outcomes reported comparably across at least three studies.
Results
Across the reviewed RCTs, mHealth interventions for COPD management among older adults were generally feasible and acceptable, but evidence for consistent clinical effectiveness was mixed. Meta-analytic findings across patient-reported outcome measures (PROMs) showed largely nonsignificant overall effects for COPD Assessment Test (CAT), St. George’s Respiratory Questionnaire (SGRQ), dyspnea, and exacerbation frequency, despite some recent adequately powered studies reporting improvements in CAT scores.
Conclusion
The evidence aligned with prior meta-analyses conducted in broader age groups, but the limited number of studies, high heterogeneity, and reliance on PROMs limit firm conclusions. Future trials should adopt standardized outcome measures, incorporate objective indicators and prioritize user-centered design to improve accessibility, engagement, and long-term adherence. mHealth applications for COPD self-management for older adults are promising but the potential is not yet realized.