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Evaluating the effect of a digital health intervention to enhance physical activity in people with chronic kidney disease (Kidney BEAM): a multicentre, randomised controlled trial in the UK

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posted on 2024-01-22, 17:01 authored by Sharlene A Greenwood, Hannah ML Young, Juliet Briggs, Ellen M Castle, Christy Walklin, Lynda Haggis, Caitlin Balkin, Elham Asgari, Sunil Bhandari, James O Burton, Roseanne E Billany, Nicolette BishopNicolette Bishop, Kate Bramham, Jackie Campbell, Joseph Chilcot, Nicola J Cooper, Vashist Deelchand, Matthew MP Graham-Brown, Alexander Hamilton, Mark Jesky, Philip A Kalra, Pelagia Koufaki, Kieran McCafferty, Andrew C Nixon, Helen Noble, Zoe Saynor, Maarten W Taal, James Tollit, David C Wheeler, Thomas J Wilkinson, Hannah Worboys, Jamie H Macdonald

Background: Remote digital health interventions to enhance physical activity provide a potential solution to improve the sedentary behaviour, physical inactivity, and poor health-related quality of life that are typical of chronic conditions, particularly for people with chronic kidney disease. However, there is a need for high-quality evidence to support implementation in clinical practice. The Kidney BEAM trial evaluated the clinical effect of a 12-week physical activity digital health intervention on health-related quality of life.

Methods: In a single-blind, randomised controlled trial conducted at 11 centres in the UK, adult participants (aged ≥18 years) with chronic kidney disease were recruited and randomly assigned (1:1) to the Kidney BEAM physical activity digital health intervention or a waiting list control group. Randomisation was performed with a web-based system, in randomly permuted blocks of six. Outcome assessors were masked to treatment allocation. The primary outcome was the difference in the Kidney Disease Quality of Life Short Form version 1.3 Mental Component Summary (KDQoL-SF1.3 MCS) between baseline and 12 weeks. The trial was powered to detect a clinically meaningful difference of 3 arbitrary units (AU) in KDQoL-SF1.3 MCS. Outcomes were analysed by an intention-to-treat approach using an analysis of covariance model, with baseline measures and age as covariates. The trial was registered with ClinicalTrials.gov, NCT04872933.

Findings: Between May 6, 2021, and Oct 30, 2022, 1102 individuals were assessed for eligibility, of whom 340 participants were enrolled and randomly assigned to the Kidney BEAM intervention group (n=173) or the waiting list control group (n=167). 268 participants completed the trial (112 in the Kidney BEAM group and 156 in the waiting list control group). All 340 randomly assigned participants were included in the intention-to treat population. At 12 weeks, there was a significant improvement in KDQoL-SF.13 MCS score in the Kidney BEAM group (from mean 44·6 AU [SD 10·8] at baseline to 47·0 AU [10·6] at 12 weeks) compared with the waiting list control group (from 46·1 AU [10·5] to 45·0 AU [10·1]; between-group difference of 3·1 AU [95% CI 1·8–4·4]; p<0·0001).

Interpretation: The Kidney BEAM physical activity platform is an efficacious digital health intervention to improve mental health-related quality of life in patients with chronic kidney disease. These findings could facilitate the incorporation of remote digital health interventions into clinical practice and offer a potential intervention worthy of investigation in other chronic conditions.

Funding

The Kidney BEAM Trial

Kidney Research UK

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National Institute for Health Research (NIHR) Leicester Biomedical Research Centre

NIHR Applied Research Collaboration East Midlands

History

School

  • Sport, Exercise and Health Sciences

Published in

The Lancet Digital Health

Volume

6

Issue

1

Pages

e23 - e32

Publisher

Elsevier

Version

  • VoR (Version of Record)

Rights holder

© The Author(s)

Publisher statement

This is an Open Access Article. It is published by Elsevier under the Creative Commons Attribution 4.0 International Licence (CC BY). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

Publication date

2023-11-14

Copyright date

2023

eISSN

2589-7500

Language

  • en

Depositor

Prof Lettie Bishop. Deposit date: 20 November 2023

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