BlackBerries good for patients’ health
COPD patients use device to send reports to researchers
TORONTO — Dave Ritchie has a BlackBerry, but he doesn’t use it as a cellphone or to receive and send e-mail. Instead, he pulls it out once a day, rolls the track wheel and clicks on it to fill out a questionnaire.
Ritchie, 80, has COPD, or chronic obstructive pulmonary disease, and he’s taking part in a year-long study that puts modified BlackBerrys in the hands of patients to find out more about their condition and what might be behind cyclical flare-ups.
"I’m not a computer geek, but I think that the BlackBerry, from my standpoint ... is a wonderful tool to use in this type of study, or any type of study," Ritchie, a retired teacher-principal, said from his home in Brantford, Ont.
"It’s the speed with which the answers can be transmitted and the speed with which things can be collated. The speed with which the data can be recorded is amazing."
For his part, he noticed his condition worsened during the warm weather this past July, as well as in November. There are signs that the Christmas-New Year’s period is a particularly rough time for some COPD patients.
Epidemiologist Neil Johnston of the Firestone Institute for Respiratory Health at St. Joseph’s Healthcare in Hamilton, Ont., is leading the study. His previous research found more asthma attacks reported in September as children return to school.
People with COPD are often smokers or former smokers who have difficulty breathing. The damage to their lungs can’t be undone, but there are treatments to help them feel better.
Those with COPD and many other chronic diseases, such as congestive heart failure, have symptoms that come and go, and they react to different things, Johnston said.
"Sometimes it’s climate, sometimes it’s food, sometimes it’s viruses and so on," he said.
"And obviously these diseases, and again COPD, they can get very bad very quickly and folks end up in hospital and in the emergency room."
Most research on COPD patients has relied on subjects to record symptoms on paper and contact a study centre by phone if they felt ill.
"People tend not to record their symptoms daily. They tend to sort of wait a week and then write them all down at once," observed Johnston, an assistant professor of medicine at McMaster University. "So it’s not a very good method of collecting the data."
Patients don’t always notice an exacerbation in their condition or don’t want to report it because they become frightened that they may get "put in hospital or something, and they hate that," Johnston said.
Enter the BlackBerry.
Every morning before taking any medication, Ritchie takes three peak flow meter readings, which measure how much pressure he can exert with his lungs, and enters the data by hand on a calendar.
In the late afternoon, he answers a series of questions on the BlackBerry. Some patients have the palm-sized devices programmed with a reminder bell, according to Johnston, but Ritchie says his doesn’t ring.
"I have no idea how to use a BlackBerry other than the fact they have given me the instructions," Ritchie said. "The questions that they wish to be answered are already in the BlackBerry."
The questions deal with frequency of coughing, breathlessness, colour of sputum, whether cold or flu symptoms are present and whether the patient saw a doctor or nurse due to a respiratory problem that day.
In addition, patients are asked for perceptions of their general state of health and if they’d like researchers to contact them.
Research In Motion Ltd., the company that makes the BlackBerry, is not involved in the project, but pharmaceutical giant AstraZeneca is funding the work through a research grant.
Johnston said the BlackBerrys are programmed so that everything is controlled with the track wheel.
"They don’t have to use the keyboard because we found that — bearing in mind these people often have visual problems — they’re very elderly in some cases, they simply can’t do that reliably, and they get frustrated if you ask them to use the keyboard," he said.
"So we put everything on the track wheel so all they have to do is roll it down, push it in."
The data are encrypted and fully secure.
"No data is retained on the BlackBerry. Everything is sent," Johnson said. "So if they lose the BlackBerry, somebody finds it, it’s no good to them and there’s no data in it."
If the researchers notice a symptom change, additional questions can be sent to the BlackBerry to find out about medications that might have been started.
The BlackBerry is not intended to be used to signal urgent help is needed. But if something is obviously going wrong, researchers monitoring responses will advise the person to contact his or her physician.
Around 40 people have joined the project to date, said Johnston.
"The fun part has been that so far, we’ve got very close to 100 per cent compliance. They love it."
Johnston said the BlackBerry has "phenomenal potential" for helping people with mental illness, or for studying teens, for instance, because you could reward them for providing data by turning on MSN, or give them a month of free long-distance calls.
Ritchie smoked until he was 35, and was exposed to second-hand smoke when he worked in a bar at a golf course after retiring.
He’s enthusiastic about taking part in this study, and says informing people about COPD is his "new passion."
"I’m very concerned about spreading the word about how to handle it, because it’s chronic, so what you’ve lost, you can’t get back," he said.
"So what you have to do is try to concentrate on what you have got so it doesn’t get you quite so fast."