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Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial

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Title: Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial
Authors: White, P
Gilworth, G
Lewin, S
Hogg, L
Tuffnell, R
Taylor, SJC
Hopkinson, NS
Hart, N
Singh, SJ
Wright, AJ
Item Type: Journal Article
Abstract: Purpose: This study was designed to evaluate the feasibility of a cluster randomized controlled trial to test the efficacy of lay health workers (LHWs) in improving the uptake and completion of pulmonary rehabilitation (PR) in the treatment of COPD. Materials and methods: LHWs, trained in confidentiality, role boundaries, and behavior change techniques, supported patients newly referred for PR. Interactions between LHWs and participants were recorded with smartphones. Outcomes were recruitment and retention rates of LHWs, questionnaire and interview-evaluated acceptability and analysis of intervention fidelity. Results: Forty (36%) of 110 PR-experienced COPD patients applied to become LHWs. Twenty (18%) were selected for training. Twelve (11%) supported patients. Sixty-six COPD patients referred for PR received the intervention (5.5 participants per LHW). Ten LHWs were retained to the end of the study. Seventy-three percent of supported patients were satisfied or very satisfied with the intervention. LHWs delivered the intervention with appropriate style and variable fidelity. LHWs would welcome more intensive training. Based on this proof of concept, a cluster randomized controlled trial of an LHW intervention to improve uptake and completion of PR is feasible. Conclusion: PR-experienced COPD patients can be recruited, trained, and retained as LHWs to support participation in PR, and can deliver the intervention. Participant COPD patients found the intervention acceptable. A cluster randomized controlled clinical trial is feasible.
Issue Date: 1-Jan-2019
Date of Acceptance: 28-Dec-2018
URI: http://hdl.handle.net/10044/1/67868
DOI: https://dx.doi.org/10.2147/COPD.S188731
ISSN: 1176-9106
Publisher: Dove Medical Press
Start Page: 631
End Page: 643
Journal / Book Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 14
Copyright Statement: © 2019 White et al. This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: NIHR ref:PB-PG-0213-30052
Keywords: completion
intervention fidelity
recruitment
retention
uptake
1102 Cardiovascular Medicine And Haematology
Respiratory System
Publication Status: Published
Conference Place: New Zealand
Online Publication Date: 2019-03-12
Appears in Collections:National Heart and Lung Institute
Airway Disease



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