New rehabilitation app to aid recovery of COVID-19 ’long-haulers’

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An innovative digital programme, developed by UCL researchers with Barts Health NHS Trust and UCL Partners, to treat the long lasting effects of COVID-19 infection, is now being used by patients.

The app, believed to be the first such tool to be rolled out in the UK, is being given to patients from Barts Health hospitals, who have been discharged but are continuing to recover and rehabilitate at home.

Over 300,000 people have been infected by COVID-19 in the UK. For many of those that survive however, this is only the start of their journey to recovery. There are increasing reports of COVID-19 survivors still suffering from debilitating symptoms of tiredness, breathlessness and anxiety many weeks and months after the peak of their infection - a group often known as the COVID-19 ’long-haulers’.

Hospitals are trying to avoid bringing patients into clinics to stop further spread of infection. But survivors report feeling abandoned and left to deal with these problems on their own.

To help combat this, a team led by UCL health researchers and computer scientists have developed a rehabilitation tool that can be delivered completely remotely. Launched this week, the tool combines evidence-based methods from physiotherapists, psychologists, dieticians and respiratory physicians to create bespoke treatment plans for each patient.

Project lead Professor Elizabeth Murray (UCL Institute of Healthcare Engineering) said: "The uniqueness of this tool is that the whole treatment programme is delivered digitally. This benefits patients unable to come into the clinic, but it also allows us to help a far greater number of people in a cost-effective and time-effective way."

Respiratory physician Dr Paul Pfeffer (St Bartholomew’s Hospital and QMUL) commented: "The proportion of people needing further help is really high. We’re finding that half of the patients we discharge from hospital are still experiencing significant symptoms after three months.

"There are simply not enough staff and resources to reach everyone recovering from COVID-19 by using the traditional models of care, such as face-to-face appointments. This tool allows us to provide high-quality treatment to large numbers of patients simultaneously."

The rehabilitation tool targets three primary symptoms being reported by ’long-haulers’ - fatigue, anxiety and breathing problems. The app is in use at Barts NHS Trust, London, with plans to roll out to three UCL Partner hospitals in the near future.

Psychologist Dr Stuart Linke (UCL Epidemiology & Health and Camden and Islington Mental Health NHS Foundation Trust), said: "The mental health component of the digital tool is just as important as the physical, and we are finding that the symptoms are often interrelated - for instance, if you’re feeling anxious you may be less likely to eat well, which may lead to further tiredness, which further impacts your mood and so on. A core feature of the recovery tool is Cognitive Behavioural Therapy (CBT) delivered by psychologists to help with anxiety."

Physiotherapist Hannah Hylton (St Bartholomew’s Hospital), said: "Issues that arise post-COVID are multi-factoral and often debilitating. For each person we are able to take a holistic approach to their treatment and provide a personalised plan via the tool, including frequent monitoring and ongoing communication."

The digital programme includes tailored advice, treatment plans and suggested exercises, and also supports clinicians with a dashboard to review patient progress and communicate, and a clinical pathway for how to provide safe, remote support. The digital tool has been developed by Living With, a private digital health company that already delivers a range of remote management products for the NHS. 

Chris Robson, CEO of Living With, commented: "We have packaged up life-changing clinical input into an app and provided it to patients through our existing remote condition management platform, to help them recover safely and comfortably from home. This launch with Barts is only the first step in turning the product into a smarter AI driven intervention that will be rolled out more widely across the UK."

The product is an interdisciplinary collaboration between a range of clinicians, (respiratory specialists, physiotherapists, dieticians, psychologists, GPs), computer scientists and health researchers from UCL, Barts NHS Health Trust, University College London Hospital, University of Southampton, University of Exeter and Living With.


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