S112 Estimating Participation Rates of COPD Patients in Pulmonary Rehabilitation and Self-Management Programmes: The Importance of Defining Participation

Abstract

Methods Patients completing PR were recruited to once weekly LTE held in accessible venues by 2 exercise instructors (Loughborough trained for exercising patients with chronic respiratory disease). Baseline demographics and disease severity were collected and outcomes: 6 minute walk test (6MWT), Hospital Anxiety & Depression (HAD) score, COPD Assessment Test (CAT), Chronic Respiratory Questionnaire (CRQ) and patient satisfaction measured at baseline, 6 and 12 months. Patients who accepted referral for LTE but never attended or dropped-out were recalled for outcomes at 12 months. Hospital admissions were audited for 12 months after PR-completion. Results Between June-2010 and January-2012 75 patients mean(SD) age 69.3(9.7)yrs, FEV 1 1.26(0.54)L, MRC 3.16(0.81) 63% female, 19.2% current smokers and 3 on LTOT accepted referral to LTE. 35% (26/75) never attended and 27%(20/75) dropped out after starting; 39% (29/75) continued to exercise for at least 6 months and 25% (19/75) exercised to 1 yr. For patients who exercised for 12 months there was no significant decline in exercise capacity (6MWT), a significant improvement in CAT over 6/12 (p=0.002) maintained to 12/12 (p=0.02) and no increase in anxiety levels, which remained below clinical relevance for the 12 months post PR. In comparison, patients who did not continue LTE had a significant (p=0.001) decline in 6MWT, no change in CAT score and a significant(p=0.04) increase in anxiety to a clinically important range (table 1). Self reported hospital admissions in the year following PR were higher for patients who did not exercise (mean 0.61 (SD 1.47)) compared to those who did, 0.16 (0.50). Conclusions This pilot demonstrates that community-based LTE with trained instructors is safe and realistic for breathless patients after completing PR and, for the first time, demonstrates significant prolongation of functional and emotional benefits. This offers acheaper, more durable alternative to repeating PR.

A pre–post intervention study of pulmonary rehabilitation for adults with post-tuberculosis lung disease in Uganda

“…At 85%, the PR completion rates in our study were high; other studies have shown that completion rates of programs of similar duration usually vary between 60% and 90%, but may be as low as 30%. 10 , 27 , 28 The national report on PR in England and Wales involving >7,000 patients showed 71% of those enrolled completed the program. 29 The high completion rates in the current study occurred despite profound transport problems in Kampala, and travel problems have been associated previously with higher dropout rates.…”

Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

“…The primary endpoint is based on a minimally important clinical difference of 35 m in the 6 MWT distance [ 43 ]. A 30% drop-out rate was anticipated [ 44 ]. Thus, a total of 54 patients (1:1 ratio) were recruited; 27 patients were enrolled in each group.…”