The digital Kaia Health mobile app helped people with chronic obstructive pulmonary disease (COPD) to better adhere to a physical activity plan after completing an in-hospital pulmonary rehabilitation program, a study found.
Moreover, the patients who used the application for six months also saw increases in exercise performance, with an easing of shortness of breath and fatigue.
“The results show significantly higher physical activity over a period of six months by using the Kaia Health COPD app compared to the control group,” Stephan Huber, MD, chief medical officer at Kaia Health, and one of the study’s authors, said in a press release.
“The Kaia Health COPD app has been proven to be an innovative way of positively influencing the health status of COPD patients over a longer period of time,” Huber said.
The company now is assessing the performance of its mobile app among those who have not yet completed a pulmonary rehab program.
“Our next goal is to demonstrate the effectiveness in patients with COPD without previous treatment in rehabilitation as part of an ongoing follow-up study,” said Huber.
The study, “Using a smartphone application maintains physical activity following pulmonary rehabilitation in patients with COPD: a randomised controlled trial,” was published in the journal Thorax.
People with COPD often undergo pulmonary rehabilitation as part of their treatment plan. This includes exercise training, health education classes, and psychological support. Several clinical trials have shown that such pulmonary rehabilitation programs boost health-related quality of life and exercise capacity.
However, evidence also suggests that COPD patients struggle to maintain physical activity and to adhere to exercise plans following the completion of these pulmonary rehabilitation programs.
Smartphone applications have been suggested as a way to help maintain access to rehab and structured exercises. But few studies have assessed whether their regular use helps patients to maintain physical activity.
“To our knowledge, this study is the first RCT [randomized controlled trial] to demonstrate the maintenance of PA [physical activity] after inpatient PR [pulmonary rehabilitation] using a digital structured programme,” the researchers wrote.
The team, from Switzerland and Germany, conducted the clinical trial (DRKS00017275) to assess whether regularly using the Kaia COPD app might help patients adhere to physical activity programs following pulmonary rehab.
The Kaia app consists of an exercise training program, breathing exercises, and an educational program. It was developed by healthcare professionals and pulmonary rehabilitation experts.
A total of 67 COPD patients, with a mean age of 64 and of whom 49.3% were women, were enrolled in the study. Each was randomly assigned to the Kaia COPD app — called the intervention group, with 33 patients — or to a control group (34 participants), in which patients received standard care. All were followed for six months after completing rehab.
COPD exercises included several daily whole-body exercises performed for 15 to 20 minutes. All exercises were explained in videos with detailed instructions.
The study’s main goal was to assess the effectiveness of the Kaia app in helping maintain physical activity, which was measured by the number of steps taken on a daily basis using an activity tracker.
Additional goals included assessing disease impact on the patient’s life, measured by the COPD assessment test (CAT) and the chronic respiratory disease questionnaire (CRQ), and changes in exercise capacity. Such changes were evaluated using the one-minute Sit-to-Stand test (STST).
CAT total scores range from zero to 40, in which higher scores reflect a more severe disease impact. STST assesses how many sit-to-stand actions a patient can perform in one minute.
In total, 60 patients completed the study. The analysis showed that the number of steps was significantly higher for COPD patients in the intervention group compared with those in the control group after six months.
Also, while CAT scores decreased in the Kaia app group after six months — indicative of less severe disease — they increased in the control group by 3.7 points as compared with the study’s start (baseline).
Shortness of breath and fatigue were significantly eased in patients who used the app.
The number of sit-to-stand actions in the STST increased significantly in the intervention group after three months compared with the control group. However, no differences were seen after six months.
“Of course, we were very pleased with these positive study results, but were not surprised,” said Rembert Koczulla, consultant pulmonologist at Kaia Health and a study co-author. “With Kaia Health, the success of the inpatient rehabilitation over six months was maintained to the greatest extent during the study.”
According to Koczulla, the findings highlight that, at the least, “slight improvements with symptoms can be achieved.”
Among participants, 13 (43%) were deemed frequent users, meaning they used the app at least four times a week for at least 70% of the study’s weeks.
A further analysis focused on this patient group alone showed an even higher difference in the main goal when compared with controls.
Overall, “this study reveals how a digital intervention can be used to supplement existing care by closing gaps in the existing healthcare landscape,” the researchers wrote.
“We are excited about the potential the Kaia Health COPD app can bring to the U.S., which adds another layer of support to our mission to make clinically validated, cost effective digital therapies accessible anytime, anywhere and for anyone,” said Nigel Ohrenstein, president of Kaia Health.