The effects of a video intervention on post-hospitalization 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 post-hospitalization pulmonary rehabilitation uptake. American Journal of Respiratory and Critical Care Medicine. ISSN 1073-449X

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Rationale: Pulmonary rehabilitation following hospitalizations for exacerbations of chronic obstructive pulmonary disease (COPD) improves exercise capacity and health-related quality of life, and reduces readmissions. However, post-hospitalization pulmonary rehabilitation uptake is low. To date, no trials of interventions to increase uptake have been conducted. Objective: Effect of a co-designed education video as an adjunct to usual care on post-hospitalization pulmonary rehabilitation uptake. Methods: 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 pulmonary rehabilitation information leaflet) or usual care plus the co-designed education video delivered via a handheld tablet device at discharge. Randomization used minimization to balance age, sex, forced expiratory volume in 1 second (FEV1) % predicted, frailty, transport availability and previous pulmonary rehabilitation experience. Measurements and Main Results: The primary outcome was pulmonary rehabilitation uptake within 28 days of hospital discharge. 200 patients were recruited with 196 randomized (51% female, median (interquartile range) FEV1 % predicted 36(27, 48)). Pulmonary rehabilitation uptake was 41% and 34% in the usual care and intervention groups respectively (p=0.37), with no differences in secondary (pulmonary rehabilitation referral and completion) or safety (readmissions and death) endpoints. Six of the fifteen participants interviewed could not recall receiving the video. Conclusion: A co-designed education video delivered at hospital discharge did not improve post-hospitalization pulmonary rehabilitation uptake, referral or completion.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: LivePure Connector
Date Deposited: 14 Mar 2020 10:24
Last Modified: 31 May 2020 23:55
DOI: 10.1164/rccm.201909-1878OC

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