Cargando…
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...
Autores principales: | , , , , , |
---|---|
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 |
_version_ | 1782502709542256640 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5279070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT jonesarwelw systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd AT taylorabigail systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd AT gowlerholly systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd AT okellynoel systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd AT ghoshsudip systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd AT bridlechristopher systematicreviewofinterventionstoimprovepatientuptakeandcompletionofpulmonaryrehabilitationincopd |