Kohlbrenner Dario, Kuhn Manuel, Kläy Adrian, Sievi Noriane A, Muszynski Michal, Ivankay Adam, Gross Christoph S, Asisof Alina, Brunschwiler Thomas, Clarenbach Christian F
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Int J Chron Obstruct Pulmon Dis. 2024 Dec 24;19:2739-2750. doi: 10.2147/COPD.S487105. eCollection 2024.
To investigate the effectiveness of 12-weeks hybrid virtual coaching on health-related quality-of-life (HrQoL) in patients with stable COPD.
We equipped all patients with a CAir Desk for telemonitoring, the intervention group additionally received hybrid virtual coaching through the built-in smartphone. The multimodal intervention based on the Living well with COPD programme, containing educational content, physical activity coaching, and home-based exercises. Primary outcome was HrQoL as measured by the SGRQ. Secondary outcomes were symptom burden, physical activity, functional exercise capacity, and lung function. Between-group differences were calculated using linear regression models, controlling for baseline differences.
We included 30 participants with COPD (13/17 women/men; 63 [9] years; FEV 54 [22] % predicted), 24 (80%) completed the study. SGRQ improved in both groups (intervention: -4.5 [20.1]; control: -2.7 [7.4] points) without statistically significant or clinically relevant between-group differences (B = -2.5 points, 95% CI = -24.3, 19.3, p = 0.81). Physical activity increased only in the intervention group (313 [1561] vs -364 [2399] steps) without statistically significant but clinically relevant between-group difference (B = 2147 steps, 95% CI = -86, 4395, p = 0.06). Symptom burden decreased in both groups (-4.2 [6.7] vs -1.0 [2.8] points) without statistically significant but clinically relevant between-group difference (B = -3.0 points, 95% CI = -10.8, 5.0, p = 0.43).
Twelve-weeks hybrid virtual coaching did not improve HrQoL more than telemonitoring only in patients with stable COPD. The intervention group improved their physical activity and symptom burden clinically relevant more than the control group.
探讨为期12周的混合式虚拟指导对稳定期慢性阻塞性肺疾病(COPD)患者健康相关生活质量(HrQoL)的有效性。
我们为所有患者配备了用于远程监测的CAir Desk,干预组通过内置智能手机额外接受混合式虚拟指导。基于慢性阻塞性肺疾病良好生活计划的多模式干预,包括教育内容、体育活动指导和家庭锻炼。主要结局是通过圣乔治呼吸问卷(SGRQ)测量的HrQoL。次要结局是症状负担、体育活动、功能锻炼能力和肺功能。使用线性回归模型计算组间差异,并控制基线差异。
我们纳入了30例慢性阻塞性肺疾病患者(女性/男性为13/17;63[9]岁;预测第一秒用力呼气容积(FEV)为54[22]%),24例(80%)完成了研究。两组的SGRQ均有所改善(干预组:-4.5[20.1];对照组:-2.7[7.4]分),但组间差异无统计学意义或临床相关性(B=-2.5分,95%置信区间=-24.3,19.3,p=0.81)。仅干预组的体育活动增加(313[1561]步对-364[2399]步),组间差异无统计学意义但具有临床相关性(B=2147步,95%置信区间=-86,4395,p=0.06)。两组的症状负担均下降(-4.2[6.7]对-1.0[2.8]分),组间差异无统计学意义但具有临床相关性(B=-3.0分,95%置信区间=-10.8,5.0,p=0.43)。
对于稳定期慢性阻塞性肺疾病患者,为期12周的混合式虚拟指导在改善HrQoL方面并不比单纯远程监测更有效。干预组在体育活动和症状负担方面的改善在临床上比对照组更显著。