Outcome measures in a combined exercise rehabilitation programme for adults with COPD and chronic heart failure: A preliminary stakeholder consensus event

Abstract

Combined exercise rehabilitation for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) is potentially attractive. Uncertainty remains as to the baseline profiling assessments and outcome measures that should be collected within a programme. Current evidence surrounding outcome measures in cardiac and pulmonary rehabilitation were presented by experts at a stakeholder consensus event and all stakeholders ( n = 18) were asked to (1) rank in order of importance a list of categories, (2) prioritise outcome measures and (3) prioritise baseline patient evaluation measures that should be assessed in a combined COPD and CHF rehabilitation programme. The tasks were completed anonymously and related to clinical rehabilitation programmes and associated research. Health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes (median rank: 1, 2 and 3 accordingly) and research purposes (median rank; 1, 3 and 4.5 accordingly) within combined exercise rehabilitation. All stakeholders agreed that profiling symptoms at baseline were ‘moderately’, ‘very’ or ‘extremely’ important to assess for clinical and research purposes in combined rehabilitation. Profiling of frailty was ranked of the same importance for clinical purposes in combined rehabilitation. Stakeholders identified a suite of multidisciplinary measures that may be important to assess in a combined COPD and CHF exercise rehabilitation programme.

Self-management interventions for adults living with Chronic Obstructive Pulmonary Disease (COPD): The development of a Core Outcome Set for COMPAR-EU project

“…The COS we present is novel since it focuses specifically on SMIs for COPD. Previous studies have focused on COPD management or other conditions [87][88][89]. Spargo et al [87] developed a COS for trials investigating the long-term management of bronchiectasis combining an overview of systematic reviews and qualitative studies and a Delphi panel that included mostly health professionals who rated the importance of each outcome initially selected.…”

“…Verburg et al [ 88 ] developed a standard set of outcome domains and proposed measures for patients with COPD for Dutch primary care physical therapy using a consensus-driven modified RAND-UCLA appropriateness method with relevant stakeholders. Jones et al [ 89 ] created a priority list of measures for a combined COPD and heart failure exercise rehabilitation program through a stakeholders consensus event.…”

Integrating patients with chronic respiratory disease and heart failure into a combined breathlessness rehabilitation programme: a service redesign and pilot evaluation

“…Following a consensus event which reviewed the current evidence surrounding outcome measures in PR and CR, health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes. 37 Overall, this data indicate that a BR programme is effective at improving generic outcomes for participants regardless of their primary diagnosis. However, although the symptom of breathlessness improved statistically Open access within the group it did not meet the MCID and therefore may not be clinically relevant.…”

Mapping the global research landscape and hotspot of exercise therapy and chronic obstructive pulmonary disease: A bibliometric study based on the web of science database from 2011 to 2020

“…European and American countries have explored the initial research plan and gradually improved their research ideas to achieve clinical utility. In particular, both Imperial College London and the University of Toronto started early and have obtained some high-quality scientific clinical outcomes, including breathlessness rehabilitation ( Man et al, 2016 ) and outcome measures combined ET ( Jones et al, 2019 ), and the effects of post-rehabilitation exercise based on community ( Butler et al, 2020 ). The researchers also explored the pulmonary protection mechanisms of COPD-related quadriceps muscle dysfunction, including sex differences ( Sharanya et al, 2019 ), utilization of non-invasive imaging tools ( Rozenberg et al, 2017 ), handgrip strength reflection ( Fonseca et al, 2021 ), the clustering physiological responses to arm activity ( Lima et al, 2016 ), and the physical activity during moderate (out-patient managed) ( Alahmari et al, 2016 ).…”