Kidney Beam-A Cost-Effective Digital Intervention to Improve Mental Health

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

doi:10.1016/j.ekir.2024.08.030

Kidney Beam-A Cost-Effective Digital Intervention to Improve Mental Health

Kidney Int Rep. 2024 Sep 2;9(11):3204-3217. doi: 10.1016/j.ekir.2024.08.030. eCollection 2024 Nov.

Authors

Sharlene A Greenwood^{1

2}, Juliet Briggs¹, Christy Walklin¹, Emmanuel Mangahis¹, Hannah M L Young^{3

4}, Ellen M Castle⁵, Roseanne E Billany⁶, Elham Asgari⁷, Sunil Bhandari⁸, Nicolette Bishop⁹, Kate Bramham², James O Burton⁶, Jackie Campbell¹⁰, Joseph Chilcot¹¹, Nicola Cooper¹², Vashist Deelchand¹³, Matthew P M Graham-Brown⁶, Lynda Haggis², Alexander Hamilton¹⁴, Mark Jesky¹⁵, Philip A Kalra¹⁶, Pelagia Koufaki¹⁷, Kieran McCafferty¹⁸, Andrew C Nixon^{19

20}, Helen Noble²¹, Zoe L Saynor²², Maarten W Taal²³, James Tollitt¹⁶, David C Wheeler²⁴, Thomas J Wilkinson²⁵, Hannah Worboys¹², Jamie Macdonald²⁶

Affiliations

¹ Renal Therapies Department, King's College Hospital, London, UK.
² Centre for Nephrology, Urology and Transplantation, Faculty of Life Sciences, King's College London, London, UK.
³ Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁴ Diabetes Research Centre, University of Leicester, Leicester, UK.
⁵ School of Physiotherapy, Department of Health Sciences, Brunel University, London, UK.
⁶ Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
⁷ Department of Nephrology, Guys and St Thomas's Hospital, London, UK.
⁸ Department of Nephrology, Hull University Teaching Hospitals NHS Trust, Hull, UK.
⁹ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
¹⁰ Faculty of Health, Education and Society, University of Northampton, Northampton, UK.
¹¹ Department of Psychology, Psychology and Neuroscience, King's College London, London, UK.
¹² Department of Population Health Science, University of Leicester, Leicester, UK.
¹³ Department of Nephrology Royal Free Hospital, London, UK.
¹⁴ Dept of Nephrology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
¹⁵ Department of Nephrology, Nottingham NHS Trust, Nottingham, UK.
¹⁶ Department of Nephrology Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
¹⁷ Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography Division, Queen Margaret University, Edinburgh, UK.
¹⁸ Department of Nephrology, Barts Health NHS Trust, London, UK.
¹⁹ Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
²⁰ Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK.
²¹ School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
²² School of Health Sciences, University of Southampton, Southampton, UK.
²³ Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, Nottingham, UK.
²⁴ Department of Renal Medicine, University College London, London, UK.
²⁵ National Institute of Health Research Leicester Biomedical Research Centre, Leicester, UK.
²⁶ Institute for Applied Human Physiology, Bangor University, Bangor, UK.

Abstract

Introduction: There is inequity in the provision of physical rehabilitation services for people living with chronic kidney disease (CKD). The Kidney BEAM trial evaluated the clinical value and cost effectiveness of a physical activity digital health intervention (DHI) in CKD.

Methods: In a single-blind, 11 center, randomized controlled trial, 340 adult participants with CKD were randomly assigned to either the Kidney BEAM physical activity DHI or a waitlist control. This study assessed the difference in the Kidney Disease Quality of Life Short Form 1.3 Mental Component Summary (KDQoL-SF1.3 MCS) between intervention and control groups at 6-months, and cost-effectiveness of the intervention.

Results: At 6-months, there was a significant difference in mean adjusted change in KDQoL MCS score between Kidney BEAM and waitlist control (intention-to-treat adjusted mean: 5.9 [95% confidence interval, CI: 4.4-7.5] arbitrary units [AU], P < 0.0001), and a 93% and 98% chance of the intervention being cost-effective at a willingness-to-pay threshold of £20,000 and £30,000 per quality-adjusted life year gained.

Conclusion: The Kidney BEAM physical activity DHI is a clinically valuable and cost-effective means to improve mental health-related quality of life (HRQoL) in people with CKD (trial registration no. NCT04872933).

Keywords: chronic kidney disease; cost-effectiveness; digital health intervention; physical activity; quality of life.

Associated data

ClinicalTrials.gov/NCT04872933