Cargando…
Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design
BACKGROUND: As population ageing accelerates worldwide, chronic diseases will place an increasing burden on society and healthcare systems. Self-management interventions may become a key strategy for addressing chronic disease burden and healthcare costs, also in pulmonary rehabilitation (PR). One o...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203526/ https://www.ncbi.nlm.nih.gov/pubmed/37228588 http://dx.doi.org/10.3389/fresc.2023.1178823 |
_version_ | 1785045653746876416 |
---|---|
author | Ricke, Ellen Dijkstra, Arie Bakker, Eric W. |
author_facet | Ricke, Ellen Dijkstra, Arie Bakker, Eric W. |
author_sort | Ricke, Ellen |
collection | PubMed |
description | BACKGROUND: As population ageing accelerates worldwide, chronic diseases will place an increasing burden on society and healthcare systems. Self-management interventions may become a key strategy for addressing chronic disease burden and healthcare costs, also in pulmonary rehabilitation (PR). One of the challenges here is long-term adherence. Understanding the level of adherence to PR may help inform clinical decision-making to focus more on self-management and less on clinical supervision. For this reason, a prediction model (PATCH) was developed. The presented protocol concerns a study that aims 1. to evaluate the safety and effectiveness of self-management within pulmonary rehabilitation (PR) on health outcomes in patients with chronic obstructive pulmonary disease (COPD), 2. to evaluate the predictive validity of the PATCH tool, and 3. to evaluate feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. METHODS AND ANALYSIS: This is a protocol of a hybrid type 1 effectiveness-implementation design, performed in primary physiotherapy practices in The Netherlands. The aim is to include 108 patients with COPD who have already followed PR for at least six weeks (maintenance stage of PR). According to the Dutch KNGF Guideline COPD, physiotherapists should reduce the number of supervised treatments after the maintenance phase and support self-management. In practice, this does not (always) happen. This protocol is based on implementing guideline advice: clinical supervision will be halved but patients are stimulated to engage in self-management by exercising unsupervised, leading to no change in the total planned exercise frequency. During the supervised sessions physiotherapists will assess and stimulate self-management. At baseline, and after 3, 6, 9 and 12 months, health outcomes (including adherence) will be evaluated as the primary outcome of this study. At each measurement, the physiotherapist will decide on the basis of individual scores whether the patient needs more clinical supervision or not. Secondary outcomes are the discriminatory power of the PATCH tool (can patients be correctly classified as adherent or non-adherent), and feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. Questionnaires and semi-structured interviews will be used for assessment of the outcomes. Trial registration number: METc 2023/074. |
format | Online Article Text |
id | pubmed-10203526 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102035262023-05-24 Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design Ricke, Ellen Dijkstra, Arie Bakker, Eric W. Front Rehabil Sci Rehabilitation Sciences BACKGROUND: As population ageing accelerates worldwide, chronic diseases will place an increasing burden on society and healthcare systems. Self-management interventions may become a key strategy for addressing chronic disease burden and healthcare costs, also in pulmonary rehabilitation (PR). One of the challenges here is long-term adherence. Understanding the level of adherence to PR may help inform clinical decision-making to focus more on self-management and less on clinical supervision. For this reason, a prediction model (PATCH) was developed. The presented protocol concerns a study that aims 1. to evaluate the safety and effectiveness of self-management within pulmonary rehabilitation (PR) on health outcomes in patients with chronic obstructive pulmonary disease (COPD), 2. to evaluate the predictive validity of the PATCH tool, and 3. to evaluate feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. METHODS AND ANALYSIS: This is a protocol of a hybrid type 1 effectiveness-implementation design, performed in primary physiotherapy practices in The Netherlands. The aim is to include 108 patients with COPD who have already followed PR for at least six weeks (maintenance stage of PR). According to the Dutch KNGF Guideline COPD, physiotherapists should reduce the number of supervised treatments after the maintenance phase and support self-management. In practice, this does not (always) happen. This protocol is based on implementing guideline advice: clinical supervision will be halved but patients are stimulated to engage in self-management by exercising unsupervised, leading to no change in the total planned exercise frequency. During the supervised sessions physiotherapists will assess and stimulate self-management. At baseline, and after 3, 6, 9 and 12 months, health outcomes (including adherence) will be evaluated as the primary outcome of this study. At each measurement, the physiotherapist will decide on the basis of individual scores whether the patient needs more clinical supervision or not. Secondary outcomes are the discriminatory power of the PATCH tool (can patients be correctly classified as adherent or non-adherent), and feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. Questionnaires and semi-structured interviews will be used for assessment of the outcomes. Trial registration number: METc 2023/074. Frontiers Media S.A. 2023-05-09 /pmc/articles/PMC10203526/ /pubmed/37228588 http://dx.doi.org/10.3389/fresc.2023.1178823 Text en © 2023 Ricke, Dijkstra and Bakker. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Rehabilitation Sciences Ricke, Ellen Dijkstra, Arie Bakker, Eric W. Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title | Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title_full | Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title_fullStr | Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title_full_unstemmed | Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title_short | Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
title_sort | feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design |
topic | Rehabilitation Sciences |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203526/ https://www.ncbi.nlm.nih.gov/pubmed/37228588 http://dx.doi.org/10.3389/fresc.2023.1178823 |
work_keys_str_mv | AT rickeellen feasibilityeffectivenessandsafetyofselfmanagementinpulmonaryrehabilitationastudyprotocolusingahybridtype1effectivenessimplementationdesign AT dijkstraarie feasibilityeffectivenessandsafetyofselfmanagementinpulmonaryrehabilitationastudyprotocolusingahybridtype1effectivenessimplementationdesign AT bakkerericw feasibilityeffectivenessandsafetyofselfmanagementinpulmonaryrehabilitationastudyprotocolusingahybridtype1effectivenessimplementationdesign |