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- Title
The Effects of a Video Intervention on Posthospitalization Pulmonary Rehabilitation Uptake. A Randomized Controlled Trial.
- Authors
Barker, Ruth E.; Jones, Sarah E.; Banya, Winston; Fleming, Sharon; Kon, Samantha S. C.; Clarke, Stuart F.; Nolan, Claire M.; Patel, Suhani; Walsh, Jessica A.; Maddocks, Matthew; Farquhar, Morag; Bell, Derek; Wedzicha, Jadwiga A.; Man, William D.-C.
- 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.
- Subjects
RANDOMIZED controlled trials; HOSPITAL care; OBSTRUCTIVE lung diseases; REHABILITATION; EDUCATIONAL films; RESEARCH; EXERCISE tolerance; RESEARCH methodology; RESPIRATORY measurements; AUDIOVISUAL materials; PATIENT readmissions; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; QUALITY of life; FORCED expiratory volume; KAPLAN-Meier estimator; PATIENT compliance; PATIENT education; EXERCISE therapy; VIDEO recording; DISCHARGE planning
- Publication
American Journal of Respiratory & Critical Care Medicine, 2020, Vol 201, Issue 12, p1517
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.201909-1878OC