Abstract
Improving exercise capacity is a primary objective in chronic obstructive pulmonary disease (COPD). Declines in exercise capacity result in reduced physical activity (PA) and health-related quality of life (HRQL). Self-management interventions can teach patients skills and behaviours to manage their disease. Technology-mediated interventions have the potential to provide easily accessible support for disease self-management. We evaluated the effectiveness of a web-based self-management intervention, focused on PA promotion, on exercise capacity in COPD. This 6-month randomised controlled trial (NCT02099799) enrolled 153 persons with COPD at two U.S. sites (VABoston, n=108; VABirmingham, n=45). Participants were allocated (1:1) to the web-based self-management intervention (PA promotion through personalised, progressive step-count goals, feedback, online COPD-related education, and social support via an online community), or usual care. The primary outcome was exercise capacity (6-min walk test distance [6 MWD]). Secondary outcomes included PA (daily steps per day), HRQL (St. George's Respiratory Questionnaire Total Score), dyspnoea, COPD-related knowledge, and social support. Change in step-count goals reflected intervention engagement. Participants were 69±7 years old, mean FEV1% predicted 61±21%. Change in 6 MWD did not differ between groups. Intervention participants improved daily step counts by an average of 1312 more than usual care (p<0.001). Groups did not differ on other secondary outcomes. VABirmingham participants were significantly more engaged with the intervention, although site did not modify the effect of the intervention on 6 MWD or secondary outcomes. The intervention did not improve exercise capacity, but improved PA at 6 months. Additional intervention modifications are needed to optimise its COPD self-management capabilities.
Footnotes
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Conflict of interest: Dr. Stephanie Robinson has nothing to disclose.
Conflict of interest: Dr. J. Allen Cooper has nothing to disclose.
Conflict of interest: Rebekah Goldstein has nothing to disclose.
Conflict of interest: Madeline Polak has nothing to disclose.
Conflict of interest: Paola Cruz Rivera has nothing to disclose.
Conflict of interest: Dr. David Gagnon has nothing to disclose.
Conflict of interest: Amber Samuelson has nothing to disclose.
Conflict of interest: Sheila Moore has nothing to disclose.
Conflict of interest: Reema Kadri has nothing to disclose.
Conflict of interest: Dr. Caroline Richardson has nothing to disclose.
Conflict of interest: Dr. Marilyn Moy has nothing to disclose.
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- Received March 8, 2021.
- Accepted June 15, 2021.
- Copyright ©The authors 2021
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