ASPIRE: Investigation of the impact of Wellinks on quality of life and clinical outcomes in patients with COPD (Preprint)

BACKGROUND Wellinks is a virtual disease management solution that provides a remote chronic obstructive pulmonary disease (COPD) care model. OBJECTIVE This study evaluated satisfaction and engagement, and explored clinical outcomes associated with participation with Wellinks. This study also sought to refine the cadence of health coaching for COPD patients. METHODS A 24-week interventional research study was conducted by Wellinks and the COPD Foundation in 2022. Adults with COPD were recruited by the COPD Foundation and determined to be eligible if they had phone and internet access and owned a smartphone. All study participants provided written informed consent. The Wellinks solution included virtual health coaching, virtual pulmonary rehabilitation, virtual group education, and access to the Wellinks app and Bluetooth-connected spirometer and pulse oximeter. All participants were offered six coaching sessions in the first 12 weeks. For the second 12-week period, by balanced assignment, participants either continued access to coaching at a reduced frequency or discontinued coaching; all other components of the Wellinks solution remained unchanged through the study duration. COPD Self-Efficacy Scale (CSES), Modified Medical Research Council (mMRC) Dyspnea Scale, pulmonary function, pulse oximetry and patient-reported healthcare resource utilization were the clinical outcome measures. Nonclinical outcomes included engagement and satisfaction with Wellinks as well as net promoter score. RESULTS 141 adults consented and completed Wellinks onboarding. Eighty-four percent completed the 24-week study. Participants had a mean age of 70 (range: 48-88), 81% were ≥65 years, and 56% were female. Most participants (84%) completed all six coaching sessions during the first 12-week period. Compliance with spirometer and pulse oximeter use was 66% to 75% early in the study in Weeks 2-4 but waned over time. Similar findings were observed with use of the Wellinks app. Regardless of group assignment, participants indicated a high degree of satisfaction with Wellinks, with ≥90% of participants indicating they agreed/strongly agreed that the educational content, health coaching, and devices were valuable. At the end of the study, the net promoter score was +64 and +55 in the coaching continuation and discontinuation arms, respectively. A statistically significant improvement from baseline to end of study was observed in the CSES total score (P < .001) and domain scores (P < .001 for each domain). 35% of participants improved their dyspnea score from baseline to week 24. CONCLUSIONS This study confirmed the feasibility of using a virtual model of care delivery to support people living with COPD. The insights gained in this study have allowed for further refinement and personalization of the Wellinks model of care. Findings related to the combined use of technology and personal care delivery should be considered by others developing remote disease management tools. CLINICALTRIAL ClinicalTrials.gov NCT05259280