Tools
Tools
Brockwell, Claire, Stockl, Andrea, Clark, Allan 
ORCID: https://orcid.org/0000-0003-2965-8941, Barton, Garry, Pasteur, Mark, Fleetcroft, Robert, Hill, Janice and Wilson, Andrew M.
(2020)
Randomised controlled trial of the effect, cost and acceptability of a bronchiectasis self-management intervention.
Chronic Respiratory Disease, 17.
ISSN 1479-9723
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Abstract
Background: Patient self-management plans (PSMP) are advised for bronchiectasis but their efficacy is not established. We aimed to determine whether, in people with bronchiectasis, the use of our bronchiectasis PSMP - Bronchiectasis Empowerment Tool (BET), compared to standard care, would improve self-efficacy. Methods: In a multi-centre mixed-methods randomised controlled parallel study, 220 patients with bronchiectasis were randomised to receive standard care with or without the addition of our BET plus education sessions explaining its use. BET comprised an action plan, indicating when to seek medical help based on pictorial represented indications for antibiotic therapy, and four educational support sections. At baseline and after 12 months, patients completed the Self-Efficacy to Manage Chronic Disease Scale (SEMCD), St George’s Respiratory Questionnaire (SGRQ), EQ-5D-3L (to calculate Quality Adjusted Life Years (QALYs) and cost questionnaires. Qualitative data were obtained by focus groups. Results: The recruitment to the study was high (63% of eligible patients agreeing to participate) however completion rate was low (57%). BET had no effect on SEMCD (mean difference (0.14 (95% confidence interval (95%CI) -0.37 to 0.64), p=0.59) or SGRQ, exacerbation rates, overall cost to the NHS or QALYs. Most had developed their own techniques for monitoring their condition and they did not find BET useful as it was difficult to complete. Participant knowledge was good in both groups. Conclusion: The demand for patient support in bronchiectasis was high suggesting a clinical need. However, the BET did not improve self-efficacy, health related quality of life, costs or clinically relevant outcome measures. BET needs to be modified to be less onerous for users and implemented within a wider package of care. Further studies, particularly those evaluating people newly diagnosed with bronchiectasis, are required and should allow for 50% withdrawal rate or utilise less burdensome outcome measures. Clinical trials registration: ISRCTN ISRCTN 18400127. Registered 24 June 2015. Retrospectively Registered
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability statement: The datasets used and analysed during the current study are available from the corresponding author on reasonable request. Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0711-25123). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. |
| Uncontrolled Keywords: | bronchiectasis,st george’s respiratory questionnaire,mixed-methods,patient self-management plans,self-efficacy to manage chronic disease scale,pulmonary and respiratory medicine ,/dk/atira/pure/subjectarea/asjc/2700/2740 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Social Sciences > Research Groups > Migration Research Network Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 17 Jul 2020 23:47 |
| Last Modified: | 17 Dec 2024 01:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/76171 |
| DOI: | 10.1177/1479973120948077 |
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