Digitalizing multidisciplinary pulmonary rehabilitation in COPD with a smartphone application: an international observational pilot study.
- Rassouli F Lung Center, Department of Internal Medicine, Cantonal Hospital St Gallen, St Gallen, Switzerland, frank.rassouli@kssg.ch.
- Boutellier D Kaia Health GmbH, Munich, Germany.
- Duss J Kaia Health GmbH, Munich, Germany.
- Huber S Kaia Health GmbH, Munich, Germany.
- Brutsche MH Lung Center, Department of Internal Medicine, Cantonal Hospital St Gallen, St Gallen, Switzerland, frank.rassouli@kssg.ch.
- 2018-12-13
Published in:
- International journal of chronic obstructive pulmonary disease. - 2018
COPD
pulmonary rehabilitation
telehealth care
telerehabilitation
Combined Modality Therapy
Europe
Exercise Therapy
Exercise Tolerance
Feasibility Studies
Health Status
Humans
Lung
Mobile Applications
Patient Compliance
Patient Education as Topic
Pilot Projects
Pulmonary Disease, Chronic Obstructive
Recovery of Function
Self Care
Smartphone
Telerehabilitation
Time Factors
Treatment Outcome
English
Background
Concerning COPD, pulmonary rehabilitation (PR) has a positive effect on disease progression and mortality, is cost-effective, and is a part of recommendations of international guidelines. Only a minority of patients profit from conventional PR due to a lack of resources, physicians' guideline adherence, or patients' motivation. Novel digital therapies like Kaia COPD, a smartphone application that digitizes PR in COPD, are promising solutions to fill this void.
Methods
Kaia COPD provides a digital version of PR and is certified as a class-I medical device in the European Union. We investigated anonymized data from users of the Kaia COPD app on in-app retention and the change in health-related quality of life (COPD assessment test and Chronic Respiratory Disease Questionnaire [CRQ]) during a period of 20 exercise days with the app.
Results
Of 349 app downloads, 56 users fulfilled inclusion criteria and 34 (61%) had finished day 20 at the time of analysis and were included. Users took 33±11 days to complete the 20-day core program. Users finishing the program reduced their COPD assessment test scores (mean 2.5 units from 21.6±7.7 to 19.1±8.4 units, P=0.008). In finishers, there was a statistically significant effect above the minimum clinically important threshold of the CRQ score on the domains of fatigue, mastery, and emotional function. There was a statistically significant but not clinically relevant effect on the domain of dyspnea of CRQ.
Conclusion
Digitalizing PR with a smartphone app is feasible and accepted by selected patients. The app leads to short-term improvement of health-related quality of life in patients completing a 20-day core program. Due to its observational character, this study has several methodological limitations and was intended to show the feasibility and to extrapolate effect sizes for planned prospective randomized-controlled trials to confirm these findings.
Concerning COPD, pulmonary rehabilitation (PR) has a positive effect on disease progression and mortality, is cost-effective, and is a part of recommendations of international guidelines. Only a minority of patients profit from conventional PR due to a lack of resources, physicians' guideline adherence, or patients' motivation. Novel digital therapies like Kaia COPD, a smartphone application that digitizes PR in COPD, are promising solutions to fill this void.
Methods
Kaia COPD provides a digital version of PR and is certified as a class-I medical device in the European Union. We investigated anonymized data from users of the Kaia COPD app on in-app retention and the change in health-related quality of life (COPD assessment test and Chronic Respiratory Disease Questionnaire [CRQ]) during a period of 20 exercise days with the app.
Results
Of 349 app downloads, 56 users fulfilled inclusion criteria and 34 (61%) had finished day 20 at the time of analysis and were included. Users took 33±11 days to complete the 20-day core program. Users finishing the program reduced their COPD assessment test scores (mean 2.5 units from 21.6±7.7 to 19.1±8.4 units, P=0.008). In finishers, there was a statistically significant effect above the minimum clinically important threshold of the CRQ score on the domains of fatigue, mastery, and emotional function. There was a statistically significant but not clinically relevant effect on the domain of dyspnea of CRQ.
Conclusion
Digitalizing PR with a smartphone app is feasible and accepted by selected patients. The app leads to short-term improvement of health-related quality of life in patients completing a 20-day core program. Due to its observational character, this study has several methodological limitations and was intended to show the feasibility and to extrapolate effect sizes for planned prospective randomized-controlled trials to confirm these findings.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.2147/COPD.S182880
- PMID 30538444
- Persistent URL
- https://sonar.ch/global/documents/13333
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