A randomised trial of a web-based physical activity self-management intervention in COPD.

Autor:	Robinson SA; Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.; Pulmonary Division, Boston University School of Medicine, Boston, MA, USA., Cooper JA Jr; Birmingham VA Medical Center, Birmingham, AL, USA.; Pulmonary, Allergy and Critical Care Medicine, Dept of Medicine, University of Alabama at Birmingham, AL, USA., Goldstein RL; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA., Polak M; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA., Cruz Rivera PN; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA., Gagnon DR; Dept of Biostatistics, Boston University School of Public Health, Boston, MA, USA.; Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA, USA., Samuelson A; Birmingham VA Medical Center, Birmingham, AL, USA., Moore S; Birmingham VA Medical Center, Birmingham, AL, USA., Kadri R; Dept of Family Medicine, University of Michigan, Ann Arbor, MI, USA., Richardson CR; Dept of Family Medicine, University of Michigan, Ann Arbor, MI, USA., Moy ML; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2021 Aug 31; Vol. 7 (3). Date of Electronic Publication: 2021 Aug 31 (Print Publication: 2021).
DOI:	10.1183/23120541.00158-2021
Abstrakt:	Improving exercise capacity is a primary objective in COPD. Declines in exercise capacity result in reduced physical activity and health-related quality of life (HRQoL). 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 physical activity promotion, on exercise capacity in COPD. This 6-month randomised controlled trial (NCT02099799) enrolled 153 persons with COPD at two US sites (VABoston, n=108; VABirmingham, n=45). Participants were allocated (1:1) to the web-based self-management intervention (physical activity 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 distance (6 MWD)). Secondary outcomes included physical activity (daily steps per day), HRQoL (St. George's Respiratory Questionnaire Total Score), dyspnoea, COPD-related knowledge and social support. Change in step-count goals reflected intervention engagement. Participants' mean age was 69 (sd=7), and mean forced expiratory volume in 1 s % predicted was 61% (sd=21%). Change in 6MWD did not differ between groups. Intervention participants improved their mean daily step counts by 1312 more than those in the usual care group (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 6MWD or secondary outcomes. The intervention did not improve exercise capacity but improved physical activity at 6 months. Additional intervention modifications are needed to optimise its COPD self-management capabilities. Competing Interests: Conflict of interest: J.A. Cooper Jr has nothing to disclose. Conflict of interest: R.L. Goldstein has nothing to disclose. Conflict of interest: M. Polak has nothing to disclose. Conflict of interest: P.N. Cruz Rivera has nothing to disclose. Conflict of interest: D.R. Gagnon has nothing to disclose. Conflict of interest: A. Samuelson has nothing to disclose. Conflict of interest: S. Moore has nothing to disclose. Conflict of interest: R. Kadri has nothing to disclose. Conflict of interest: C.R. Richardson has nothing to disclose. Conflict of interest: M.L. Moy has nothing to disclose. (Copyright ©The authors 2021.)
Databáze:	MEDLINE
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