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Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD

Pulmonary rehabilitation is considered a key management strategy for chronic obstructive pulmonary disease (COPD), but its effectiveness is undermined by poor patient uptake and completion. The aim of this review was to identify, select and synthesise the available evidence on interventions for impr...

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Autores principales: Jones, Arwel W., Taylor, Abigail, Gowler, Holly, O'Kelly, Noel, Ghosh, Sudip, Bridle, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279070/
https://www.ncbi.nlm.nih.gov/pubmed/28154821
http://dx.doi.org/10.1183/23120541.00089-2016
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author Jones, Arwel W.
Taylor, Abigail
Gowler, Holly
O'Kelly, Noel
Ghosh, Sudip
Bridle, Christopher
author_facet Jones, Arwel W.
Taylor, Abigail
Gowler, Holly
O'Kelly, Noel
Ghosh, Sudip
Bridle, Christopher
author_sort Jones, Arwel W.
collection PubMed
description Pulmonary rehabilitation is considered a key management strategy for chronic obstructive pulmonary disease (COPD), but its effectiveness is undermined by poor patient uptake and completion. The aim of this review was to identify, select and synthesise the available evidence on interventions for improving uptake and completion of pulmonary rehabilitation in COPD. Electronic databases and trial registers were searched for randomised trials evaluating the effect of an intervention compared with a concurrent control group on patient uptake and completion. The primary outcomes were the number of participants who attended a baseline assessment and at least one session of pulmonary rehabilitation (uptake), and the number of participants who received a discharge assessment (completion). Only one quasi-randomised study (n=115) (of 2468 records identified) met the review inclusion criteria and was assessed as having a high risk of bias. The point estimate of effect did, however, indicate greater programme completion and attendance rates in participants allocated to pulmonary rehabilitation plus a tablet computer (enabled with support for exercise training) compared with controls (pulmonary rehabilitation only). There is insufficient evidence to guide clinical practice on interventions for improving patient uptake and completion of pulmonary rehabilitation in COPD. Despite increasing awareness of patient barriers to pulmonary rehabilitation, our review highlights the existing under-appreciation of interventional trials in this area. This knowledge gap should be viewed as an area of research priority due to its likely impact in undermining wider implementation of pulmonary rehabilitation and restricting patient access to a treatment considered the cornerstone of COPD.
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spelling pubmed-52790702017-02-02 Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD Jones, Arwel W. Taylor, Abigail Gowler, Holly O'Kelly, Noel Ghosh, Sudip Bridle, Christopher ERJ Open Res Review Pulmonary rehabilitation is considered a key management strategy for chronic obstructive pulmonary disease (COPD), but its effectiveness is undermined by poor patient uptake and completion. The aim of this review was to identify, select and synthesise the available evidence on interventions for improving uptake and completion of pulmonary rehabilitation in COPD. Electronic databases and trial registers were searched for randomised trials evaluating the effect of an intervention compared with a concurrent control group on patient uptake and completion. The primary outcomes were the number of participants who attended a baseline assessment and at least one session of pulmonary rehabilitation (uptake), and the number of participants who received a discharge assessment (completion). Only one quasi-randomised study (n=115) (of 2468 records identified) met the review inclusion criteria and was assessed as having a high risk of bias. The point estimate of effect did, however, indicate greater programme completion and attendance rates in participants allocated to pulmonary rehabilitation plus a tablet computer (enabled with support for exercise training) compared with controls (pulmonary rehabilitation only). There is insufficient evidence to guide clinical practice on interventions for improving patient uptake and completion of pulmonary rehabilitation in COPD. Despite increasing awareness of patient barriers to pulmonary rehabilitation, our review highlights the existing under-appreciation of interventional trials in this area. This knowledge gap should be viewed as an area of research priority due to its likely impact in undermining wider implementation of pulmonary rehabilitation and restricting patient access to a treatment considered the cornerstone of COPD. European Respiratory Society 2017-01-30 /pmc/articles/PMC5279070/ /pubmed/28154821 http://dx.doi.org/10.1183/23120541.00089-2016 Text en Copyright ©ERS 2017. http://creativecommons.org/licenses/by-nc/4.0/ This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Review
Jones, Arwel W.
Taylor, Abigail
Gowler, Holly
O'Kelly, Noel
Ghosh, Sudip
Bridle, Christopher
Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title_full Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title_fullStr Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title_full_unstemmed Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title_short Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD
title_sort systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in copd
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279070/
https://www.ncbi.nlm.nih.gov/pubmed/28154821
http://dx.doi.org/10.1183/23120541.00089-2016
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