attended a screening visit; 58/129 screen failed (eg, due to deterioration in peak flow, unable to wean off regular asthma medications) leaving 71 randomised (2.5%) of total patients invited. Trial 2: similar picture, completed July 2011, extended by 6 months due to slow recruitment. Target to randomise ¼80, target to complete ¼68. Actual completed: 71/8398 (<1%) of those invited. Conclusion Achieving the completion target in randomised controlled trials requires significant administrative support, and the capacity to increase support should difficulties in recruitment be encountered. Closer partnership with primary care practitioners, better access to primary care patient databases and direct contact with potential recruits can overcome this. Loss of potential recruits during the run-in phase needs exploration, and is of significant importance to improve the efficiency of screening to randomisation. Addressing these issues will mean fewer trials are underpowered and hence provide better return for grant awarding bodies.
1:Breathing pattern dysfunction (BPD) is linked to disproportionate dyspnoea and a myriad of symptoms that can affect quality of Rationale life (QoL). Asthma patients in particular have a high prevalence of BPD. The Nijmegen questionnaire (NQ) is a validated outcome measure of BPD in patients with no underlying respiratory pathophysiology, however, it is not validated in patients with organic disease such as asthma. The Juniper Asthma Quality of Life Questionnaire (AQLQ) and the Dyspnoea 12 (D12) are validated outcome measures for the asthma patient population assessing QoL and are linked to severity of disease. The aim of this study is to assess the benefit of physiotherapy input, specifically breathing retraining, in a severe asthma patient population known to a tertiary centre. Pre and post AQLQ, D12 and NQ scores were compared to assess the effectiveness of physiotherapy breathing retraining on patients with severe asthma and BPD.: We included physiotherapy referrals to the outpatient department of the Royal Brompton Hospital for patients diagnosed with Method asthma and BPD. All patients were referred via a consultant and had a diagnosis of breathing pattern dysfunction based on clinical assessment. Severe asthma diagnoses were confirmed after patients completed a systematic asthma assessment at the Royal Brompton. BPD patients without an asthma diagnosis were excluded. The AQLQ, D12 and NQ scores were primary outcome measures for improvement and were completed before and after 4 Physiotherapy interventions. Secondary outcome measures included respiratory rate (RR). : Initial data was available for 16 patients, 11 female, 5 male, mean (S.D) age = 41.4 (11.3). Pre and post scores were available for 4 Results patients and are presented in the table below as mean (S.D): Mean (S.D) Mean Change pre total AQLQ 3.37(0.89) 0.93* post total AQLQ 4.3(0.97) 0.93* pre Nijmegen 40(12.75) 14.25 post Nijmegen 25.75(7.59) 14.25 pre D12 23.5(10.21) 7.75 post D12 15.75(6.55) 7.75 pre RR 20.25(4.5) 4.75 post RR 15.5(0.58) 4.75 * = clinical significance All scores improved post physiotherapy intervention, mean change for the AQLQ is clinically significant at 0.93. All other measures have improved, though we are unable to comment on statistical significance at present. Data collection is ongoing and will be presented in full at ATS conference. :There is a clinically significant improvement in QoL post physiotherapy intervention in patients with severe asthma as Conclusion measured by the AQLQ. These results are mirrored by improvements in both the NQ and the D12. This abstract is funded by: None Am J Respir Crit Care Med 185;2012:A2755 Internet address: www.atsjournals.org Online Abstracts Issue
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