ABSTRACT
Keywords: Chronic Kidney Disease;Wellbeing;Telerehabilitation Purpose: To establish and evaluate a novel digital intervention to provide people living with chronic kidney disease (CKD) across the UK a means to manage their physical health and emotional wellbeing through the Coronavirus-19 (COVID-19) pandemic and beyond. There is a significant association between CKD and more severe COVID-19 infection and a greater mortality rate than the general population. People living with end-stage CKD were classified as ‘extremely clinically vulnerable’ and asked to shield at home. Since people living with CKD do not receive routine physical and emotional wellbeing support as part of routine NHS care, a home-based solution was developed to fill this urgent need. Methods: We partnered with online exercise platform Beam to co-design Kidney Beam (https://beamfeelgood.com/home), a kidney-specific digital health platform, which aimed to offer people living with CKD a way to improve physical and mental health through live and on demand movement classes and educational videos from multidisciplinary experts, all from their own home. The platform was free at point of access for all adults with CKD. A voluntary survey collecting demographic data was completed by participants on sign-up and upon completion of the 6-month pilot to establish whether participants were meeting current physical activity guidelines, to investigate perceptions of health, and collect usability feedback about the platform. Results: A total of 959 participants aged > 18 years from across the UK signed up to the platform within the 6-month time period. Of these, 71% were female, 50% were pre-dialysis and 32% had received a kidney transplant. A total of 1,105 on-demand classes and 829 live classes were completed. The pre-pilot survey was completed by 276 participants (29%), with 76 completing the post-pilot survey. The sample was representative of the baseline sign-ups. Responders to the survey had an 8% improvement in general health (change from perception of poor or fair health to good or very good health) by the end of the pilot. Additionally, 6% of responders reported an improvement in the perception of their emotional health. The pre-pilot survey revealed that only 31% of responders were achieving the recommended physical activity levels of > 150 minutes weekly moderate intensity activity, which had increased to 50% of post-pilot responders. Strength training on 2 days of the week was reported by 31% of responders pre-pilot, compared with 42% post-pilot. 96% of participants would recommend Kidney Beam to a friend, with the biggest reported benefits being that it was kidney-specific and delivered by specialist kidney healthcare professionals. Conclusion(s): The Kidney Beam pilot was a pragmatic programme of care, rapidly evolved to deliver vital physical activity and emotional wellbeing support to people living with CKD at a time of crisis. This platform has been funded for a further 12 months, whilst a randomised controlled trial to evaluate clinical efficacy and cost effectiveness is undertaken to help inform NHS commissioning of the programme. Impact: This has been granted funding for an RCT to evaluate clinical efficacy and cost effectiveness. If successful this will lead to the potential for NHS commissioning, as part of routine care. Funding acknowledgements: The pilot study was a collaboration between King's College Hospital, Kidney Research UK (KRUK) and Beam, a health-technology platform supporting people with health conditions to stay physically active. This work was not funded by the CSP Charitable Trust.