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NHS Dumfries and Galloway – Pulmonary Rehabilitation Service

How ARMED Technology is supporting healthier lifestyles for patients with chronic lung conditions in Dumfries and Galloway.

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Summary

The Pulmonary Rehabilitation Service run by NHS Dumfries and Galloway Health and Social Care Partnership supports people with chronic lung conditions such as COPD and the impacts of COVID to remain physically active and self-manage their condition. 

A six-week exercise and education programme run by a multi-disciplinary team including physiotherapists, nurses and respiratory doctors, helps provide the foundations for better health, both physically and mentally, which in turn can improve quality of life and reduce hospital admissions.

Advanced Risk Modelling for Early Detection (ARMED) technology is being piloted to help wearers to increase their daily activity levels with a view to reducing re-referral numbers to the programme after a year.

Wearable tech can help increase motivation for greater activity

Before the COVID-19 pandemic, around 70 patients a week would take part in the Pulmonary Rehabilitation programme to help build their activity and fitness levels. However once the programme was finished, activity levels tended to drop off, and associated health benefits reduced.

Within a year, around 5% of patients would end up being re-referred to the same programme. Any patients who were re-admitted to hospital had to be seen within four weeks and some would rejoin the programme several times a year. This put considerable resource pressure on the service, which already has a considerable waiting list.

Dumfries and Galloway covers a large region which is extremely rural in places, the ability to keep connected with and support patients is vital to help them manage their conditions.

As part of the EU funded mPower project, the decision was taken to introduce ARMED software and wearables to help patients monitor their own activity and motivate them to keep exercising. With a focus on social prescribing and increasing the use of digital health solutions at the heart of mPower’s objectives, it was felt that ARMED could enhance access to the existing services within the region.

ARMED allows the team to look at the data remotely and see where patients may be experiencing difficulty and determine if they need extra support. Participants in the Pulmonary Rehabilitation trial use wearables that can track their activity and remind them if they needed to move more during the day. The wearable technology combines pioneering predictive data analytics modelling and health and social care data.

Lisa McLachlan is a Specialist Physiotherapist in Pulmonary Rehabilitation and Community Respiratory for NHS Dumfries and Galloway. She says: “We realised there was a gap in our service once the six-week programme had ended and we thought it would be interesting to see what the patients were doing after that. We thought that if they could see their own activity levels and also know that we were keeping an eye on them, which could keep them more active.”

Data monitoring helps to support patients to remain active

Introducing the devices during the six-week programme ensured participants were confident using the technology before they were discharged. Lisa says: “Some patients are more tech friendly than others. The majority our patients are more elderly and less tech friendly but have taken it on, learned the basics and then built on it.”

The team meets regularly to interpret the data and ensure any issues are highlighted.
Ewan Marshall, mPower Co-Implementation Lead, says: “We have had times when people are not well so we have been able to liaise with Lisa’s team for advice about what they can do and alleviate any problems before they get too bad.”

Regularly monitoring the activity data allows the team to see where levels are dipping, investigate the cause and support the patient to resume activity. Spotting the change in the activity data of a patient who, for example, has hurt their back enables the team to track the patient, realise there is an issue and work with them. In the nine months since the pilot has been running there have been no re-referrals to the programme among the participants, and no hospital admittance.

Regular contact with wellbeing teams as a result of the pilot is also proving beneficial. Ewan says: “We have a reflective conversation about how they’re getting on and they’re always appreciative of that. From a social point of view it’s a really good conversation starter, we might talk about their garden and where they’ve been walking. It could be the only conversation they have had that day or even that week.
 
“If that gives them a good feeling at the end of it, they may get up and go back out again. We have seen that time and time before, but now we have the evidence to show it. This is something we have never had before.”

If you would like to find out more about ARMED please email: enquiries@technicare.solutions or call 07850 318 950.