Smartphone application-based pulmonary rehabilitation in COPD: a multicentre randomised controlled trial.

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 60-70) and forced expiratory volume in 1 s 48% predicted (IQR 37-60). 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, 2); p=0.7); 1MSTST improved by 1 vs 2 repetitions, respectively (difference: 1 repetition (95% CI: 0, 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, 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.