EC Pulmonology and Respiratory Medicine

Objective: This study aimed to evaluate the clinical efficacy of a Hospital-Community-Home (3H) digital management platform in improving self-management behaviors of patients with chronic obstructive pulmonary disease (COPD), identify deficiencies and bottlenecks encountered during real-world implementation, and provide evidence-based references for optimizing digitalized management strategies for COPD.

Methods: A COPD digital management platform was constructed based on 5G information technology to establish the integrated 3H service model, supported by a joint management team consisting of respiratory specialists and community general practitioners. A single-group pre-post self-controlled trial was conducted. A total of 1,000 patients meeting the diagnostic criteria outlined in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 were recruited on a voluntary basis and stratified into GOLD A, B, C, and D subgroups. All participants received standardized continuous management for 14 months. The platform dynamically collected baseline demographic data, medication adherence indicators (regular refill frequency and duration of continuous medication), histories of acute exacerbations, and responses to a disease awareness questionnaire. Retrospective statistical analyses were performed using SPSS 26.0 software.

Results: Ultimately, 985 patients completed the full 14-month digital management program. Patients classified as GOLD A and B accounted for 86.93% of the total cohort, substantially exceeding the proportion of GOLD C and D patients (13.07%). In terms of age distribution, 84.67% of participants were aged 50 - 79 years, 6.19% were younger than 50 years, and 9.14% were aged ≥80 years; the 60-69-year age bracket dominated the GOLD A subgroup. Urban residents constituted 69.04% of the study population versus 30.96% rural patients, with urban patients demonstrating a markedly higher monthly regular medication refill rate (90.29% vs. 12.79%). Only 30.86% of all participants maintained standardized continuous medication for more than 12 months, with subgroup proportions of 15.86% (A), 35.26% (B), 69.50% (C), and 57.14% (D), respectively. Following implementation of the digital platform intervention, patients’ medication adherence rose significantly from 23.35% to 66.29%, median disease awareness scores increased from 2 to 6 points, and the total number of patients experiencing acute exacerbations declined from 20 to 11 (all P < 0.01).

Conclusion: COPD patients enrolled in digitalized management exhibit significant disparities in disease severity stratification, urban-rural distribution, and long-term regular medication compliance. The 3H integrated digital management platform effectively standardizes patients’ self-management behaviors, enhances medication adherence and disease cognition, and reduces the risk of COPD acute exacerbations.

Keywords: Chronic Obstructive Pulmonary Disease; 3H Digital Management Platform; Self-Management Behaviors; Effectiveness Evaluation

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