Web-based self-management support increased physical activity in people with COPD

Web-based self-management support led to short-term increases in physical activity among adults with COPD, researchers reported at the European Respiratory Society International Congress.

“Over the last decade, a large number of research studies has taught us the importance of physical activity within the COPD population, the close link between physical activity and important clinical outcomes, as well as the prognosis of the disease,” Andre Nyberg, PhD, associate professor and researcher in the department of community medicine and rehabilitation at Umeå University, Sweden, said during a presentation. “Finding effective strategies aiming to improve physical activity has been, and still is, an essential goal within the management of the disease.”

This pragmatic randomized controlled trial included 146 adults with COPD (mean age, 69.5 years; 47.2% women) in Sweden. Participants were randomly assigned to the web-based self-management support group (n = 73) or the control group (n = 73). In addition to usual care — which included information on the importance of physical activity and a step counter — participants in the intervention group also received access to COPD Web, which is an interactive website that builds on national and international COPD treatment guidelines with specific focus on self-management. Participants have the ability to learn the positive effects of physical activity, how to find the right level when exercising and how to facilitate physical activity through this intervention. Researchers also sent weekly prompts to patients with information on physical activity in relation to COPD, encouragement to use COPD Web and a reminder to use the step registration function on the website.

Other than an initial phone call during the first week of the study period, there was no contact between participants and the researchers or any health care professional, so all information on using the tool, accessing physical activity sections and setting the daily step goal was available through COPD Web content.

Researchers reported clinically relevant improvement in objectively measured steps per day at 3 months, with 1,227 more steps among participants in the intervention group compared with the control group (1,100 vs. 600 per day). On a more individual level, roughly 40% to 50% of participants in the intervention group reached the clinically relevant cutoff for physical activity of 1,100 steps. This was almost twofold the number of participants in the control group.

The researchers also conducted individual interviews with patients with access to COPD Web to evaluate the potential mechanism of effects of using this kind of intervention in this patient population.

“What we found in these interviews was that the patients that had used this web-based self-management tool, they feel empowered by using the tool and the tool boosted their level of agency as well as their ability to improve their physical activity level,” Nyberg said. “Overall, by using this type of web-based support, the patients felt that it improved their sense of control of the situation, and it improved it to such an extent that this improvement in physical activity was possible.”