S86 A single-blind, multicentre, multinational, randomised controlled trial of online singing for Lung Health (SLH) vs usual care for people with COPD: the Singing for Health, Improving Experiences of Lung Disease (SHIELD) Trial

Abstract

Background Singing for Lung Health (SLH) is an arts‐based non‐pharmacological intervention for people with long‐term respiratory conditions that aims to improve symptoms and quality of life (QOL). Current research suggests face‐to‐face SLH can improve aspects of QOL and physical performance. There is interest in online, remotely delivered SLH, however no previous studies have assessed its impact. Methods A single blind randomised controlled trial comparing the impact of 12 weeks of once‐weekly online SLH to usual care (UC) on health related quality of life (HRQoL) (RAND SF‐36 Mental (MHC) and Physical (PHC) health composite scores). Secondary outcome measures were breathlessness (MRC dyspnoea scale and Dyspnoea‐12), physical activity (daily step‐count and PROactive cPACC), balance confidence (ABC score), anxiety (GAD‐7), depression (PHQ‐19) and COPD symptoms (CAT score). Results 115 participants with stable COPD were recruited and allocated into well‐matched study arms. Median (IQR) age of 69 (62‐74); 56.5% female; 87.8% White British ethnicity; 80% previously participated in pulmonary rehabilitation; MRC dyspnoea scale median (IQR) 4 (3‐4); FEV1% predicted 49 (35 to 63); 13.0% current smokers, mean (SD) packyears 33.5 (20.3), BMI 25.7 (6.3); 10.4% were using supplementary oxygen therapy. 50 participants in each arm completed the study. Compared with UC, SLH participation was associated with preferable changes to the RAND SF‐36 PHC (regression coefficient 1.77 [95%CI 0.11 ‐ 3.44]; p=0.037)) but not MHC. No statistically significant between groups differences were observed in secondary outcome measures in the prespecified intention to treat analyses. In a prespecified responder analysis based on achieving a 10% improvement from baseline, the response rate for PHC was 32% of the SLH arm and 12.7% of UC (p=0.024). A statistically significant between group difference was not found in relation to a 10% improvement from baseline for the SF‐36 MHC. More adverse events were reported in the UC(n=22) than SLH (n=16) arm. Discussion & Conclusion Our findings suggest that a 12‐week online SLH intervention can improve the physical component of HRQoL for people with COPD. Online SLH may be a useful addition to COPD management for selected individuals.