More people with chronic obstructive pulmonary disease (COPD) could soon access rehabilitation programmes after draft guidance from NICE conditionally recommended two technologies to provide digital services to NHS patients.
According to NHS Digital, approximately 1.17 million people in England have been diagnosed as living with COPD in 2021. It is estimated that a further 2 million remain undiagnosed.
COPD is a long-term and progressive respiratory condition that causes breathlessness, a persistent chesty cough, persistent wheezing and frequent chest infections. COPD includes chronic bronchitis and emphysema.
Respiratory tract infections, smoking, and environmental pollutants can cause symptoms of COPD to exacerbate or “flare up” and result in increased breathlessness or coughing, leading to urgent hospital care for some people. Exacerbations caused by COPD are the second most common cause of emergency hospital admissions, accounting for 1 in 8 of all UK hospital admissions.
Evidence suggests that 90% of patients who complete a face-to-face pulmonary rehabilitation programme experience increased exercise capacity and improved quality of life. However according to the NHS Long Term Plan, they are currently only offered to 13% of eligible patients, with a focus on those with more severe COPD.
NICE's medical technologies advisory committee has recommended two digital technologies, myCOPD and SPACE for COPD, to deliver pulmonary rehabilitation which are exercise and education programmes for people with COPD. Both digital technologies offer exercise programmes and education sessions to help with people with COPD manage their own condition in a place and time of their choosing.
The two digital platforms could be appropriate for those people who do not have a service where they live, do not wish to be seen in person, or would prefer not to be treated in person for convenience. The committee agreed with experts that the two digital programmes would not replace face-to-face pulmonary rehabilitation in the care pathway.
Mark Chapman, interim director of the Health Technologies Programme at NICE, said: “There is a huge unmet need for access to pulmonary rehabilitation programmes by people with COPD. Our committee hopes by recommending two digital technologies which provide these programmes they could help people living in areas without access to an in-person service to receive the vital care they need.
“With more than a million people suffering from this debilitating condition, it’s important that NICE continues to focus on what matters most and continue to provide useful and useable guidance for the conditions which severely impact people and the health service.”
It is recommended the two digital technologies are used by the NHS whilst further evidence is generated to address evidence gaps. There are no safety concerns with delivering pulmonary rehabilitation programmes via the digital technologies. These technologies can be used once they have appropriate regulatory approval and meet the standards within NHS England’s Digital Technology Assessment Criteria.
A consultation has now begun on the recommendations and comments can be submitted via nice.org.uk until Wednesday 10 January 2024.
