Beginning in 2011 with the release of the updated GOLD guidelines and the American Thoracic Society guidelines, the evaluation of chronic obstructive pulmonary disease (COPD) patients changed dramatically. Instead of picking an inhaler or combination of inhalers based on spirometry alone, the new guidelines combined validated patient questionnaires, spirometry, and COPD exacerbation frequency to paint a broader picture of COPD patients. While we're seeing increasing use of tools like smart inhalers and COPD apps to help automatically generate that data, gathering it in a single clinic visit can be tough.
The 2016 GOLD guidelines continue to recommend this assessment using either the COPD Assessment Test (CAT) or the modified Medical Research Council Scale (mMRC) to perform this assessment. These are much shorter questionnaires than the most commonly used research questionnaire, the St George's Respiratory Questionnaire (SGRQ). Interestingly, the CAT is owned by GlaxoSmithKline and can only be accessed via their website or the new COPD Pocket Consultant app. The mMRC can be found in some medical calculator apps.
The app includes the two most recommended COPD patient assessment questionnaires -- the CAT and the mMRC -- in app form, along with a full patient assessment that includes spirometry and COPD exacerbations. This full assessment is the current recommended method for determining which medications should be prescribed to COPD patients by the 2016 GOLD and 2011 ATS/ACP COPD guidelines. Unfortunately, the CAT is literally owned by GlaxoSmithKline (GSK) and this is likely why it is only available via this app, which is sponsored by GSK and the COPD Foundation.
Price: Free
Likes:
- Only app that includes the COPD Assessment Test (CAT).
- Includes both CAT and mMRC calculators.
- Allows for input of spirometry and COPD exacerbations for full patient assessment.
- Abundant additional material on COPD, links to ATS guideline, includes article on calculators, etc.
Dislikes:
- Font and layout of app difficult to read/cluttered.
- Obvious pharmaceutical company sponsorship.
- Links to some articles of questionable benefit.
- Not available for Android at this time.
Overall:
The COPD Pocket Consultant Guide app brings the cardboard drug company/COPD foundation card to life on the iPhone. It is a truly useful addition since no other calculator has the CAT and only MedCalx has the alternative MMRC test. The medical app takes the test score further by truly integrating spirometry and COPD exacerbations into the patient assessment per current COPD guideline recommendations. This combination permits the "best evidence" approach to COPD care to ensure the proper medications are utilized at the point of care. The caveat is that the evidence of efficacy for many COPD medications is weak when it comes to true patient-oriented outcomes, and both the GOLD and ATS/ACP guidelines contain a significant amount of expert opinion and pharmaceutical company ties.
Check out the full review of COPD Pocket Consultant on iMedicalApps.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. government.