Kidney Beam app significantly improves quality-of-life

The benefits of the newly developed Kidney Beam app were highlighted at the Irish Nephrology Society Winter Meeting 2024.

Dr Sharlene Greenwood, Consultant Kidney Physiotherapist at King’s College Hospital, London, UK, and lead developer of the Kidney Beam programme, gave a presentation on the digital platform.

The app was created to help people living with kidney disease manage their physical and emotional wellbeing. King’s College Hospital provides one of the few physiotherapy-led kidney rehabilitation services in England.

The meeting heard that globally, 28 per cent of adults are insufficiently active, and this sedentary behaviour will lead to 500 million new cases of non-communicable diseases before 2030. People living with chronic kidney disease (CKD) are at particular risk of sedentarism and inactivity. Recently published guidelines have suggested that all people with CKD should be encouraged to do physical activity, Dr Greenwood said; however, the patient population are not often offered such support as part of their routine care. 

When the Covid-19 pandemic started the hospital wanted to provide support online for people living with kidney disease, Dr Greenwood explained, and the Kidney Beam app was developed. It is a kidney-specific exercise and lifestyle management app designed to support, empower, and improve the lives of people living with CKD.

Dr Greenwood added that following a six-month pilot, she received further funding from Kidney Research UK to run a randomised controlled trial.

This consisted of a 12-week programme of twice-weekly sessions offered live or also on demand to accommodate people who might be at work or have other responsibilities.

The sessions were provided by specialist kidney physiotherapists and had a 10-minute warm-up and cool-down period, along with 20-to-30 minutes of moderate intensity aerobic and resistance exercise training, delivered in a standing and seated position.

This physical activity was combined with education and support, which consisted of 15 minutes of disease-specific education on a weekly basis, with topics ranging from medication information to general fitness and wellbeing. Weekly support was also provided by a physiotherapy assistant, who was trained in motivational interviewing behaviour.

“While it is physiotherapist-led, we also have other teachers and instructors on the app, some who are living with kidney disease themselves,” Dr Greenwood said.

In the trial, 340 patients were randomised equally between the Kidney Beam app intervention and the wait list control group. The results of the trial, recently published in The Lancet, show significant and clinically important effects on health-related quality-of-life for the app users, when compared with usual care, the meeting heard.

Use of the app was effective for the primary outcome of mental health-related quality-of-life and the related secondary outcomes of physical function, symptom burden, social interaction, anxiety/depression, and patient activation. Kidney Beam was also highly likely to be more cost-effective compared with usual care programmes, the meeting was told.

In the UK, 18,452 classes have been completed and the programme has a 75 per cent returning user rate among the 3,147 people who signed up. In November 2022, Kidney Beam was trialled in Ireland and Dr Greenwood highlighted that it was available for patients here, through a donation from the Punchestown Kidney Research Fund.

In Ireland, there have been 102 subscriptions, with 44 per cent completing at least one session, which is a similar percentage compared to other health apps. Some 410 sessions have been completed by “Beamers” in Ireland, 265 live classes were attended, and 145 on-demand sessions have been completed.

“We have also been working with the Irish Kidney Association, which has been fantastic. We’ve had a webinar where we’ve been able to bring some patients together to tell them about this (Kidney Beam app),” she said.

She added that there is a national virtual patient-focused ‘open evening’ planned for later this year.

Responding to questions from the floor, Dr Greenwood said that while most people had access to an internet-capable device, the programme was reaching out to people without access to mobile phones or the internet.

“We have carried out some interviews with people who don’t have access to a device or the internet at home. We are doing a pilot study with those people, where we have given them a device with Kidney Beam already installed and the internet. This is actually a fraction of the cost of some of the other healthcare delivery that we use,” she said.

Mr Colin White from the Irish Kidney Association reported that the feedback the Association has received about the app was extremely positive.

“One of the most common questions we are asked by patients with CKD or their family members is ‘what can I be doing?’, ‘Okay, I can follow the instructions from the doctor, but what can I do in my own life?’” he said.

“So having Kidney Beam as a resource to point people towards for exercise and good mental health information is a great addition.”

Other conditions such as cystic fibrosis can also be found on the website www.beamfeelgood.com.