The effects of a video intervention on posthospitalization pulmonary rehabilitation uptake

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.

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

Keywords

  • chronic obstructive pulmonary disease
  • hospitalization
  • rehabilitation

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