The effects of a video intervention on posthospitalization pulmonary rehabilitation uptake

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. and Man, William D.-C. (2020) The effects of a video intervention on posthospitalization pulmonary rehabilitation uptake. American Journal of Respiratory and Critical Care Medicine, 201 (12). pp. 1517-1524. ISSN 1073-449X

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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.

Item Type: Article
Additional Information: This article has an online supplement, which is accessible from this issue’s table of contents at www.atsjournals.org.
Uncontrolled Keywords: chronic obstructive pulmonary disease,hospitalization,rehabilitation,pulmonary and respiratory medicine,critical care and intensive care medicine ,/dk/atira/pure/subjectarea/asjc/2700/2740
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
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Depositing User: LivePure Connector
Date Deposited: 14 Mar 2020 10:24
Last Modified: 05 Oct 2020 23:55
URI: https://ueaeprints.uea.ac.uk/id/eprint/74494
DOI: 10.1164/rccm.201909-1878OC

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