Detailed Search Results
| Author/Association: | Gloeckl R, Spielmanns M, Stankeviciene A, Plidschun A, Kroll D, Jarosch I, Schneeberger T, Ulm B, Vogelmeier CF, Koczulla AR |
| Title: | Smartphone application-based pulmonary rehabilitation in COPD: a multicentre randomised controlled trial [with consumer summary] |
| Source: | Thorax 2025 Mar;80(4):209-217 |
| Method: | clinical trial |
| Method Score: | This trial has not yet been rated. |
| Consumer Summary: | WHAT IS ALREADY KNOWN ON THIS TOPIC: Pulmonary rehabilitation (PR) is widely recognised as a cornerstone in managing chronic obstructive pulmonary disease (COPD). It offers significant benefits in terms of exercise capacity, quality of life and symptom control. However, traditional face-to-face PR programmes have limitations such as limited access, capacity constraints and low uptake rates. Tele-PR has emerged as a potential solution, encompassing various modalities such as videoconferencing, webpages or mobile applications. Although some studies have shown comparable outcomes between tele-PR and centre-based PR, the follow-up effects of tele-PR, particularly application-based applicationroaches, remain underexplored. WHAT THIS STUDY ADDS: This multicentre randomised controlled trial aims to investigate the effectiveness of a fully automated, interactive smartphone application in improving symptoms and physical function in COPD. Unlike previous studies, which primarily focused on tele-PR via videoconferencing or web-based platforms, this trial specifically examines the impact of an application-based intervention. The application includes customised exercise training, educational material and breathing/ relaxation sessions, making it a comprehensive self-management tool for patients with COPD. This study enhances the existing literature by addressing the gap in knowledge regarding the effectiveness of application-based PR in COPD management, through the use of rigorous methodology and a large sample size across multiple centres. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY: The study's findings provide valuable insights into the role of mobile applications in COPD management and PR. Although the overall analysis did not show statistically significant differences between the application-using group and the enhanced standard of care group, the study highlights the potential benefits of application-based interventions, particularly for adherent users. Adherent application users showed improved exercise capacity, suggesting that the application could be a promising alternative for patients facing barriers to accessing centre-based rehabilitation (especially compared with the real-life situation where patients with COPD receive less support than in the enhanced standard of care group). Furthermore, the high patient satisfaction and safety profile of the Kaia COPD application highlight its potential as a viable option for addressing the challenges of access and adherence in PR interventions. These findings could guide future research directions, clinical guidelines and healthcare policies to enhance COPD management through innovative digital health solutions. |
| Abstract: | BACKGROUND: Pulmonary rehabilitation (PR) is an essential element of chronic obstructive pulmonary disease (COPD) management. However, access to conventional face-to-face PR programmes is limited. METHODS: This multicentre, randomised controlled trial recruited patients with COPD from 18 sites in Germany and Switzerland, aiming to evaluate the impact of 12 weeks of a mobile app (intervention group; IVG) on quality of life, measured by COPD Assessment Test (CAT), and exercise capacity, assessed by 1-minute-sit-to-stand-test (1MSTST), compared with a control group (CTG) receiving 'enhanced standard-of-care'. RESULTS: 278 patients were included in the study with a median age of 65 years (IQR 60 to 70) and forced expiratory volume in 1 s 48% predicted (IQR 37 to 60). In the intention-to-treat analysis at week 12, CAT improved from baseline by median -4 points versus -3 points in the IVG versus CTG groups, respectively (difference 0 points (95% CI -1 to 2); p = 0.7); 1MSTST improved by 1 versus 2 repetitions, respectively (difference 1 repetition (95% CI 0 to 2); p = 0.12)). In a subset of the IVG, with patients grouped by application adherence (>= 3 days/week for >= 75% of the weeks), adherent users (40.4%) improved 1MSTST versus non-adherent users by median 2 repetitions (95% CI 1 to 3); p = 0.006. Application use did not raise any safety concerns. CONCLUSIONS: Application-based PR improved outcomes in COPD compared with baseline, and adherent users improved exercise capacity more compared with non-adherent users. Although not statistically significant compared with enhanced standard-of-care, this study may support the use of this application for COPD management and addresses the healthcare challenge of access to PR interventions. TRIAL REGISTRATION NUMBER: DRKS 00024390. Reproduced with permission from the BMJ Publishing Group. Full text (sometimes free) may be available at these link(s):  help |
