A feasibility pragmatic clinical trial of a primary care network exercise and education program for people with COPD

Pilot and Feasibility Studies

Wendy M. Rodgers¹  Kelsey M. T. Hurley²  Michael K. Stickland³  Anne-Marie Selzler⁴ 

[1] Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, AB, Canada;Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, AB, Canada;Edmonton North Primary Care Network, Edmonton, AB, Canada;G.F. MacDonald Centre for Lung Health Covenant Health, Edmonton, AB, Canada;Division of Pulmonary Medicine, Department of Medicine, University of Alberta, T6G 2J3, Edmonton, AB, Canada;West Park Healthcare Centre, Toronto, ON, Canada;

关键词: Pulmonary rehabilitation;    Chronic obstructive pulmonary disease;    Primary care;    Self-management;    Self-efficacy;    Exercise;    Physical activity;   

DOI  :  10.1186/s40814-020-00705-y

来源: Springer

【 摘 要 】

BackgroundPulmonary rehabilitation is an important component of chronic disease management in chronic obstructive pulmonary disease (COPD) and has been shown to improve shortness of breath, exercise capacity, quality of life, and decrease hospitalizations. However, pulmonary rehabilitation capacity is low. Primary care may be an effective method for delivering disease management services to this population. The objective of this feasibility pragmatic clinical trial was to evaluate enrollment and completion of a primary care network exercise and education program for people with COPD.MethodsCOPD patients (N = 23; mean age = 65 ± 9 years; FEV1 = 68 ± 20% predicted) were recruited after referral to a primary care network exercise program in Edmonton, Alberta. Participants self-selected either an 8-week 16-session supervised exercise program or an 8-week unsupervised exercise program where they received three visits with an exercise specialist. Both groups self-selected education sessions with clinicians for disease management support. Referrals, completion, and program outcomes (physical activity, exercise capacity and health status) were measured before (T1), immediately after (T2), and 8 weeks following the program (T3).ResultsForty-three referrals were received in 10 months, where a minimum of 50 was required in order for the program to be considered feasible. Twenty-three participants provided baseline data, and twenty participants started the exercise program (10 in each exercise group), 16 of which completed the exercise program (80%). On average, 48% of the recommended education sessions were completed by participants.ConclusionsEnrollment into a COPD exercise and education program in a primary care network was low indicating the need for improved referral processes from physicians. Completion rates by participants were adequate for exercise but not education. The low referral rate and the lack of enrollment in COPD education by the patients indicate that a large-scale trial of the program as designed is not feasible.

【 授权许可】

CC BY