Cargando…

The Effects of a Video Intervention on Posthospitalization Pulmonary Rehabilitation Uptake. A Randomized Controlled Trial

Rationale: Pulmonary rehabilitation (PR) after hospitalizations for exacerbations of chronic obstructive pulmonary disease (COPD) improves exercise capacity and health-related quality of life and reduces readmissions. However, posthospitalization PR uptake is low. To date, no trials of interventions...

Descripción completa

Detalles Bibliográficos
Autores principales: Barker, Ruth E., Jones, Sarah E., Banya, Winston, Fleming, Sharon, Kon, Samantha S. C., Clarke, Stuart F., Nolan, Claire M., Patel, Suhani, Walsh, Jessica A., Maddocks, Matthew, Farquhar, Morag, Bell, Derek, Wedzicha, Jadwiga A., Man, William D.-C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Thoracic Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301747/
https://www.ncbi.nlm.nih.gov/pubmed/32182098
http://dx.doi.org/10.1164/rccm.201909-1878OC
Descripción
Sumario:Rationale: Pulmonary rehabilitation (PR) after hospitalizations for exacerbations of chronic obstructive pulmonary disease (COPD) improves exercise capacity and health-related quality of life and reduces readmissions. However, posthospitalization PR uptake is low. To date, no trials of interventions to increase uptake have been conducted. Objectives: To study the effect of a codesigned education video as an adjunct to usual care on posthospitalization PR uptake. Methods: The present study was an assessor- and statistician-blinded randomized controlled trial with nested, qualitative interviews of participants in the intervention group. Participants hospitalized with COPD exacerbations were assigned 1:1 to receive either usual care (COPD discharge bundle including PR information leaflet) or usual care plus the codesigned education video delivered via a handheld tablet device at discharge. Randomization used minimization to balance age, sex, FEV(1) % predicted, frailty, transport availability, and previous PR experience. Measurements and Main Results: The primary outcome was PR uptake within 28 days of hospital discharge. A total of 200 patients were recruited, and 196 were randomized (51% female, median FEV(1%) predicted, 36 [interquartile range, 27–48]). PR uptake was 41% and 34% in the usual care and intervention groups, respectively (P = 0.37), with no differences in secondary (PR referral and completion) or safety (readmissions and death) endpoints. A total of 6 of the 15 participants interviewed could not recall receiving the video. Conclusions: A codesigned education video delivered at hospital discharge did not improve posthospitalization PR uptake, referral, or completion.