Simone Dal Corso, Anne E Holland, Johnson George, Michael J Abramson, Grant Russell, Nick Zwar, Billie Bonevski, Jaycie Perryman, Narelle S Cox
{"title":"以家庭为基础的肺康复计划对COPD患者的保真度。","authors":"Simone Dal Corso, Anne E Holland, Johnson George, Michael J Abramson, Grant Russell, Nick Zwar, Billie Bonevski, Jaycie Perryman, Narelle S Cox","doi":"10.1177/14799731241307247","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> Pulmonary rehabilitation (PR) is highly effective but underutilised. Pathways to home-based PR (HBPR) from general practice could improve utilisation, but program fidelity in this setting is unknown. This study aimed to explore the fidelity of HBPR in people referred from general practice. <b>Methods:</b> Secondary analysis of intervention-group data from two-arm cluster RCT (RADICALS-interdisciplinary intervention for people with COPD including smoking cessation support, home medicine reviews and 8-weeks HBPR). HBPR fidelity assessed by the extent to which exercise training was prescribed according to protocol. Completion of HBPR and contributing factors were determined. <b>Results:</b> 107 participants (68% of intervention group) were referred to HBPR, with <i>n</i> = 75 (70%) commencing the program (mean age 68 years, FEV<sub>1</sub> 65% predicted, median mMRC 1). Aerobic training was prescribed according to protocol for 74% of participants in week one, and on average 89% of participants in weeks 2-8. Resistance training was prescribed according to protocol for 98% and 88% of participants (Week 1 and Weeks 2-8, respectively). Rehabilitation completers (<i>n</i> = 57, 76%) were 26 times more likely to have attended the Week 2 phone call (95% CI 2-352). Clinically meaningful improvements were achieved in health-related quality of life (SGRQ) and health status (CAT) following rehabilitation. <b>Conclusion:</b> PR program fidelity can be maintained when delivering HBPR to people with COPD referred directly from general practice. Early engagement with PR may be key to supporting rehabilitation completion.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"21 ","pages":"14799731241307247"},"PeriodicalIF":3.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618893/pdf/","citationCount":"0","resultStr":"{\"title\":\"Fidelity of a home-based pulmonary rehabilitation program in people with COPD referred from primary care.\",\"authors\":\"Simone Dal Corso, Anne E Holland, Johnson George, Michael J Abramson, Grant Russell, Nick Zwar, Billie Bonevski, Jaycie Perryman, Narelle S Cox\",\"doi\":\"10.1177/14799731241307247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Purpose:</b> Pulmonary rehabilitation (PR) is highly effective but underutilised. Pathways to home-based PR (HBPR) from general practice could improve utilisation, but program fidelity in this setting is unknown. This study aimed to explore the fidelity of HBPR in people referred from general practice. <b>Methods:</b> Secondary analysis of intervention-group data from two-arm cluster RCT (RADICALS-interdisciplinary intervention for people with COPD including smoking cessation support, home medicine reviews and 8-weeks HBPR). HBPR fidelity assessed by the extent to which exercise training was prescribed according to protocol. Completion of HBPR and contributing factors were determined. <b>Results:</b> 107 participants (68% of intervention group) were referred to HBPR, with <i>n</i> = 75 (70%) commencing the program (mean age 68 years, FEV<sub>1</sub> 65% predicted, median mMRC 1). Aerobic training was prescribed according to protocol for 74% of participants in week one, and on average 89% of participants in weeks 2-8. Resistance training was prescribed according to protocol for 98% and 88% of participants (Week 1 and Weeks 2-8, respectively). Rehabilitation completers (<i>n</i> = 57, 76%) were 26 times more likely to have attended the Week 2 phone call (95% CI 2-352). Clinically meaningful improvements were achieved in health-related quality of life (SGRQ) and health status (CAT) following rehabilitation. <b>Conclusion:</b> PR program fidelity can be maintained when delivering HBPR to people with COPD referred directly from general practice. Early engagement with PR may be key to supporting rehabilitation completion.</p>\",\"PeriodicalId\":10217,\"journal\":{\"name\":\"Chronic Respiratory Disease\",\"volume\":\"21 \",\"pages\":\"14799731241307247\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618893/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chronic Respiratory Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/14799731241307247\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chronic Respiratory Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/14799731241307247","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Fidelity of a home-based pulmonary rehabilitation program in people with COPD referred from primary care.
Purpose: Pulmonary rehabilitation (PR) is highly effective but underutilised. Pathways to home-based PR (HBPR) from general practice could improve utilisation, but program fidelity in this setting is unknown. This study aimed to explore the fidelity of HBPR in people referred from general practice. Methods: Secondary analysis of intervention-group data from two-arm cluster RCT (RADICALS-interdisciplinary intervention for people with COPD including smoking cessation support, home medicine reviews and 8-weeks HBPR). HBPR fidelity assessed by the extent to which exercise training was prescribed according to protocol. Completion of HBPR and contributing factors were determined. Results: 107 participants (68% of intervention group) were referred to HBPR, with n = 75 (70%) commencing the program (mean age 68 years, FEV1 65% predicted, median mMRC 1). Aerobic training was prescribed according to protocol for 74% of participants in week one, and on average 89% of participants in weeks 2-8. Resistance training was prescribed according to protocol for 98% and 88% of participants (Week 1 and Weeks 2-8, respectively). Rehabilitation completers (n = 57, 76%) were 26 times more likely to have attended the Week 2 phone call (95% CI 2-352). Clinically meaningful improvements were achieved in health-related quality of life (SGRQ) and health status (CAT) following rehabilitation. Conclusion: PR program fidelity can be maintained when delivering HBPR to people with COPD referred directly from general practice. Early engagement with PR may be key to supporting rehabilitation completion.
期刊介绍：
Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.
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