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

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

Abstract

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: Kidney Research UK.

Citation

Greenwood, S. A., Young, H. M., Briggs, J., Castle, E. M., Walklin, C., Haggis, L., Balkin, C., Asgari, E., Bhandari, S., Burton, J. O., Billany, R. E., Bishop, N. C., Bramham, K., Campbell, J., Chilcot, J., Cooper, N. J., Deelchand, V., Graham-Brown, M. M., Hamilton, A., Jesky, M., …Macdonald, J. H. (2024). 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. Lancet Digital Health, 6(1), E23-E32. https://doi.org/10.1016/S2589-7500%2823%2900204-2

• Journal Article Type: Article
• Acceptance Date: Sep 27, 2023
• Online Publication Date: Nov 13, 2023
• Publication Date: 2024-01
• Deposit Date: Oct 6, 2023
• Publicly Available Date: Nov 16, 2023
• Journal: The Lancet Digital Health
• Electronic ISSN: 2589-7500
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 1
• Pages: E23-E32
• DOI: https://doi.org/10.1016/S2589-7500%2823%2900204-2
• Keywords: Health Information Management; Decision Sciences (miscellaneous); Health Informatics; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/25682740
• Publisher URL: https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00204-2/fulltext
• Additional Information: This article is maintained by: Elsevier; Article Title: 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; Journal Title: The Lancet Digital Health; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/S2589-7500(23)00204-2; Content Type: article; Copyright: © 2023 The Author(s). Published by Elsevier Ltd.