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The effects of a video intervention on posthospitalization pulmonary rehabilitation uptake

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Authors

  • Ruth E. Barker
  • Sarah E. Jones
  • Winston Banya
  • Sharon Fleming
  • Samantha S. C. Kon
  • Stuart F. Clarke
  • Claire M. Nolan
  • Suhani Patel
  • Jessica A. Walsh
  • Matthew Maddocks
  • Morag Farquhar
  • Derek Bell
  • Jadwiga A. Wedzicha
  • William D.-C. Man

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Abstract

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, FEV1 % 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 FEV1% 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.

Details

Original languageEnglish
Pages (from-to)1517-1524
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume201
Issue number12
Early online date17 Mar 2020
DOIs
Publication statusPublished - 15 Jun 2020
Peer-reviewedYes

Keywords

    Research areas

  • chronic obstructive pulmonary disease, hospitalization, rehabilitation

Bibliographic note

This article has an online supplement, which is accessible from this issue’s table of contents at www.atsjournals.org.

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