Effects of a digital management pathway based on GOLD guidelines on acute exacerbations frequency and respiratory muscle function in patients with moderate-to-severe COPD

Chen Bo; Wang Jibing; Min Lingfeng; Yu Jiangquan; Jin Xing; Yin Zhenglu; Wang Jianjian; Meng Zhaoxiang

doi:10.11986/j.issn.1673-873X.2025.12.03

Abstract：Objective To investigate the effects of a digital management pathway based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD)guidelines on acute exacerbation frequency,respiratory muscle function,and quality of life in patients with moderate-to-severe chronic obstructive pulmonary disease(COPD),providing references for clinical de-cision-making.Methods A total of 100 patients with moderate-to-severe COPD recruited from Northern Jiangsu People's Hospital and Yangzhou Second People's Hospital from January 2020 to September 2024 were selected.Using a random number table,patients were assigned to four groups(n=25 each):routine intervention group,expectoration group,pulmo-nary rehabilitation exercise group,and drug delivery device group.The routine intervention group received standard health education and follow-up.The expectoration group received additional digitally assisted expectoration training.The pulmona-ry rehabilitation exercise group underwent digital respiratory muscle training.The drug delivery device group used an intelli-gent drug delivery management system to enhance medication adherence.The intervention lasted 48 weeks.Changes in moderate-to-severe exacerbation frequency,time to first exacerbation,pulmonary function indices(forced expiratory volume in 1 second[FEV1],forced vital capacity[FVC],FEV1/FVC ratio,maximal mid-expiratory flow[MMEF]),modified Medical Research Council(mMRC)dyspnea score,Miller and Jones classification score,6-minute walk test(6MWT)dis-tance,and COPD Assessment Test(CAT)score were compared.Results After intervention,all four groups showed sig-nificant improvement in pulmonary function indices,exercise tolerance,and quality of life compared to baseline.The drug delivery device group demonstrated the most significant effects in reducing moderate-to-severe and any-grade exacerbation frequency,delaying the time to first exacerbation,and lowering CAT scores(P<0.05).The expectoration group showed the most pronounced improvement in Miller and Jones classification score(P<0.05),indicating optimal enhancement in sputum expectoration ability.Conclusion The GOLD guideline-based digital management pathway effectively reduces acute exacerbation risk and improves respiratory muscle function,exercise tolerance,and quality of life in moderate-to-severe COPD patients.The comprehensive intervention model combining intelligent medication management with digital pulmonary rehabilitation yields particularly favorable outcomes.