Early home-based pulmonary rehabilitation following acute exacerbation of COPD: A feasibility study using an action research approach.,Chronic Respiratory Disease

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Early home-based pulmonary rehabilitation following acute exacerbation of COPD: A feasibility study using an action research approach.
Chronic Respiratory Disease ( IF 3.5 ) Pub Date : 2020-08-20 , DOI: 10.1177/1479973120949207
Bruna Wageck ₁ , Narelle S Cox _{1,

2,

3} , Janet Bondarenko ₄ , Monique Corbett ₄ , Amanda Nichols _{3,

5} , Rosemary Moore ₂ , Anne E Holland _{1,

2,

3,

4}

Affiliation

Objective:

Pulmonary rehabilitation (PR) improves function, reduces symptoms and decreases healthcare usage in people with chronic obstructive pulmonary disease (COPD) following an acute exacerbation (AECOPD). However, rehabilitation uptake rates are low. This study aimed to address barriers to uptake and completion of PR following AECOPD.

Methods:

An action research approach was used to reflect on study feasibility, and to plan and implement an improved protocol. Phase I tested the feasibility of home-based PR started early after AECOPD. Phase II used qualitative interviews to identified potential barriers to program uptake. Phase III re-tested the program with changes to recruitment and assessment strategies.

Results:

Phase I: From 97 screened patients, 26 were eligible and 10 (38%) started home-based PR. Eight participants undertook ≥70% of PR sessions, achieving clinically meaningful improvement in 6-minute walk distance (mean (SD) change 76 (60) m) and chronic respiratory disease questionnaire total score (15 (21) units). Phase II: Potential barriers to uptake of home-based PR included access issues, confidence to exercise, and lack of information about PR benefits. Phase III: From 77 screened patients, 23 were eligible and 5 (22%) started the program.

Discussion:

Home-based PR improved clinical outcomes, but program eligibility and uptake remain challenging. Efforts should be made to ensure PR program eligibility criteria are broad enough to accommodate patient needs, and new ways of engaging patients are needed to improve PR uptake after AECOPD.

中文翻译：

COPD 急性加重后的早期家庭肺康复：一项使用行动研究方法的可行性研究。

客观的：

肺康复 (PR) 可改善慢性阻塞性肺疾病 (COPD) 急性加重 (AECOPD) 患者的功能、减轻症状并减少其医疗保健使用。然而，康复接受率很低。本研究旨在解决 AECOPD 后接受和完成 PR 的障碍。

方法：

使用行动研究方法来反思研究的可行性，并计划和实施改进的方案。第一阶段测试了在 AECOPD 之后早期开始的基于家庭的 PR 的可行性。第二阶段使用定性访谈来确定计划采用的潜在障碍。第三阶段通过改变招聘和评估策略重新测试了该计划。

结果：

第一阶段：从 97 名接受筛查的患者中，26 名符合条件，10 名 (38%) 开始了基于家庭的 PR。八名参与者进行了≥70% 的 PR 会议，在 6 分钟步行距离（平均 (SD) 变化 76 (60) 米）和慢性呼吸系统疾病问卷总分（15 (21) 单位）方面实现了具有临床意义的改善。第二阶段：采用家庭 PR 的潜在障碍包括获取问题、锻炼的信心以及缺乏有关 PR 福利的信息。III 期：在 77 名接受筛查的患者中，23 名符合条件，5 名 (22%) 开始了该计划。