Hybrid Virtual Coaching and Telemonitoring in COPD Management: The CAir Randomised Controlled Study

Dario Kohlbrenner,1,2,* Manuel Kuhn,1,2,* Adrian Kläy,1,2 Noriane A Sievi,2 Michal Muszynski,3 Adam Ivankay,3 Christoph S Gross,4 Alina Asisof,4 Thomas Brunschwiler,3 Christian F Clarenbach1,2 1Faculty of Medicine, University of Zurich, Zurich, Switzerland; 2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; 3IBM Research - Europe, Zurich, Switzerland; 4Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland*These authors contributed equally to this workCorrespondence: Dario Kohlbrenner, Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland, Email [email protected]: To investigate the effectiveness of 12-weeks hybrid virtual coaching on health-related quality-of-life (HrQoL) in patients with stable COPD.Methods: 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.Results: We included 30 participants with COPD (13/17 women/men; 63 [9] years; FEV1 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).Conclusion: 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.Keywords: COPD, conversational agent, telemedicine, physical activity