Evaluating the Feasibility and Pretesting the Impact of an Educational and Telemonitoring Program for COPD Patients in Lebanon

Rita Georges Nohra,1– 3 Taghrid Chaaban,1,4 Hala Sacre,3 Pascale Salameh,3,5– 7 Zeina Aoun Bacha,8 Beatrice Le Bon Chami,9 Fadi Abou Rizk,10 Paul Makhlouf,11 Monique Rothan-Tondeur1,12 1Chaire Recherche Sciences Infirmières, Laboratoire Educations et Promotion de la santé, LEPS, Université Sorbonne Paris Nord, Villetaneuse, France; 2Faculty of Public Health, Lebanese University, Fanar, Lebanon; 3Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban, INSPECT-LB, Beirut, Lebanon; 4Faculty of Public Health, Islamic University of Lebanon, Khaldeh - Beirut, Lebanon; 5School of Medicine, Lebanese Amerian University, Byblos, Lebanon; 6Department of Research, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon; 7Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, 2417, Cyprus; 8Department of Pulmonary Disease,Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; 9Department of Pulmonary Disease, Maritime Hospital, Jbeil, Lebanon; 10Department of Pulmonary Disease, American University Medical Center Rizk Hospital, Beirut, Lebanon; 11Department of Pulmonary Disease, Notre Dame du Liban Hospital, Jounieh, Lebanon; 12Chaire Recherche Sciences Infirmières, AP-HP, Paris, FranceCorrespondence: Rita Georges Nohra, Université Sorbonne Paris Nord, Chaire Recherche Sciences Infirmières, Laboratoire Educations et Promotion de la santé, LEPS, 74 Rue Marcel Cachin, Villetaneuse, 93000, France, Tel +961 76 144 873 ; +33 7 67 23 36 34, Email Ritag.nohra@gmail.comPurpose: The objective of this study was to investigate the feasibility and pretest the effectiveness of an educational and telemonitoring program in a sample of Lebanese COPD patients to inform the design of a randomized study.Patients and Methods: This study recruited a convenient sample of 15 patients from the pulmonology departments of four hospitals. Validated questionnaires were adapted to meet the context of this study in terms of adequacy, acceptability, adoption, fidelity, and cost. The impact of this program on quality of life and anxiety was measured by the COPD Assessment Test (CAT), the COPD Clinical Questionnaire (CCQ), and the Hospital Anxiety and Depression Scale (HADS). All measurements were performed before and after the intervention.Results: All 15 participants who agreed to participate in this intervention found the program adequate and acceptable for addressing COPD-related issues. Regarding adoption, all participants declared having no difficulty explaining to others the content of the education sessions and that they would suggest this program to other COPD patients. In terms of effectiveness, six patients had improving in quality of life scores, and five patients had lower anxiety and depression scores compared to baseline measures. A knowledge assessment was done at the end of each session, showing an increase in knowledge for all participants. Skills were also assessed at the end of the program. Participants made no errors that had an impact on their health. Regarding the cost, it was difficult to evaluate the relative cost of this intervention given the economic situation in the country.Conclusion: This study is the first to evaluate the application of telehealth to optimize COPD management in Lebanon. The approach proposed gave insights into the different obstacles and facilitating factors for implementing such a project to allow a large-scale work on the adaptation of the COPD patient to his disease in Lebanon.Keywords: chronic obstructive pulmonary disease, quality of life, telehealth, knowledge, skills