A Pilot- and Feasibility Trial of the EHealth Tool My COPD for People with COPD

Chronic obstructive pulmonary disease (COPD) is one of the most common non-communicable (chronic) diseases, leading to significant increased risk of morbidity and mortality. Pulmonary rehabilitation is a comprehensive intervention, including but not limited to physical exercise, education and behavioral change. Conclusive evidence supports the provision of pulmonary rehabilitation in adults with COPD, which benefits exercise tolerance, physical activity, health-related quality of life, health care use, and survival. However, access to pulmonary rehabilitation needs to be increased, which has recently been highlighted as a top priority by leading experts in the area.

To increase access to evidence-based treatment for people with COPD this research group has developed a novel eHealth tool, My COPD, in co-creation with intended end-users to meet requirements and needs of adults with COPD and health care providers. My COPD includes components to promote physical exercise, education and behavioral change, for example, information on disease management and treatment, symptom diary, an individualized physical exercise and activity plan, support from physiotherapist as well as self-management strategies. My COPD will be available on a nation-wide platform for internet-based support- and treatment programs that regional health care regions throughout Sweden offers.

The research aim of this trial is to explore the users' satisfaction, reach and safety of My COPD, and to collect and synthesize data on clinical outcome measures to inform the sample size estimation of a later definitive trial. For this purpose, the investigators will conduct a multi-center, parallel-group randomized controlled pilot- and feasibility trial, with usual care as comparison group (control), for the duration of 12 weeks. In total, 30 adults with stable COPD will be recruited from hospitals and primary care centers located in public health regions in central (Region Stockholm) and northern (Region Västerbotten) Sweden.

All participants will be invited to complete an initial screening and baseline assessment before the randomization and intervention commences. Descriptive baseline assessments that will be collected include assessment of pulmonary function (spirometry), while having usual bronchodilator therapy according to guidelines. Anthropometric data collected will include age, sex, height, weight, and body mass index. Further data that will be collected include information on smoking status, education, and co-morbidities and medications that may influence physical capacity or activity.

At completion of informed consent, enrolment and baseline assessment procedures, participants will be randomized to either the intervention group (My COPD) or control group (usual care). Randomization will be conducted using opaque envelopes, and administered by a researcher not involved in the assessment procedures, thus, ensuring concealed allocation. Participants will be randomized to the intervention (My COPD) and control group (usual care) group, using a 2:1 allocation ratio and stratified by sex and center.

Before and after the 12-week intervention assessments of exercise capacity, balance, level of physical activity, health related quality of life, COPD related symptoms, health economics will be conducted in all participants. During the intervention, data on exercise intensity, adverse events, adherence and progression will be collected from participants in the intervention group via My COPD. At intervention completion the user satisfaction of participants and health care professionals in the intervention group will be assessed. Participants in both groups will be asked to describe their COPD-related health care contacts during the study period. Physiotherapists, blinded to group allocation and previous test results, will conduct assessments.