Experts have supported a call for the NHS to roll out an innovative digital exercise scheme aimed at tackling an unprecedented rise in cardio-kidney-metabolic (CKM) conditions such as heart disease, kidney disease, diabetes and obesity.
Rates of CKM disease are increasing so quickly that charity Kidney Research UK have described it as a “public health emergency” - warning the cost to the economy could rise from £7 billion to almost £14 billion in as little as eight years’ time.
In a new white paper "Reimagining rehabilitation for people with cardio-kidney-metabolic conditions - from inactivity to empowerment”, a group of clinicians, researchers and patients support the case for rolling out a specialised digital physical therapy and education programme, proven in a landmark clinical trial to improve health and lower costs for the health service.
Professor Jamie Macdonald, Professor in Sport & Exercise at Bangor University, is a key contributor to the paper. He said:
“Quality of life is substantially reduced in people living with kidney disease. Many of the causes of poor quality of life revolve around poor physical function, co-morbidities such as cardiovascular disease, symptoms such as fatigue, and psychological impacts such as depression. Encouragingly, many of these causes are modifiable with rehabilitation. We need to remove every possible barrier to participate in rehabilitation in this population.”
Professor Sharlene Greenwood, a consultant physiotherapist at King’s College Hospital London and author of the paper, said:
“Increasing physical activity and improving lifestyle management can have a profound impact on slowing disease progression - yet only 3 out of 72 units in the NHS offer dedicated physio-led rehabilitation for this patient cohort, compounded by an acute workforce crisis.”
“The urgent need for innovative, scalable solutions is clear. Only digital tools - supplemented by human clinical expertise - can bring about interventions big enough to meet the avalanche of demand we know is coming.”
The alarming rise in CKM conditions poses major economic and social challenges for the UK, with kidney disease affecting 7.2 million people, diabetes 6 million, and cardiovascular disease 7.2 million. There’s growing recognition that these diseases often co-exist and exacerbate each other, creating complexity and costing the NHS tens of billions of pounds to treat.
According to Kidney Wales, there are 93,722 people diagnosed with chronic kidney disease in Wales at stages 1-5 of illness.
The risk of death can be reduced by up to a third in this patient group if they exercise, plus they are 21% less likely to need intensive treatment options such as transplants or dialysis.
In the new white paper, compelling evidence is presented from a clinical trial published in the Lancet Digital Health last year, showing a significant improvement in health outcomes for patients who completed the 12-week rehabilitation programme on the Kidney Beam digital health platform. In addition, the intervention was found to save almost £600 per patient - and projected to save over £140 million in total for the NHS in reduced hospital admissions, medical appointments and medication spend over three years.
Sandra Currie OBE, chief executive of Kidney Research UK and author of the foreword in the paper, said:
“Kidney Research UK is urgently sounding the alarm bell about the rapid growth in kidney disease prevalence and its associated risk factors. Technology is a vital tool in ensuring patient care is prioritised at this crucial time.”
“Professor Greenwood’s clinical trial has confirmed that people using the platform see improvements in their mental health, their physical function, their energy levels and their ability to self-manage their conditions … and offers the NHS significant cost savings. The evidence is clear and the time is right. We must make this life-changing intervention available across the entire NHS.”
The paper also features contributions from leading voices from the National Kidney Federation, UK Kidney Association, NIHR Research Delivery Network, and the Sheffield Area Kidney Association.