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P47 Outcomes of static vs continuous rolling community pulmonary rehabilitation (PR) programmes
  1. JL Tomkinson,
  2. M Rossdale
  1. Bristol Community Health, Bristol, Bristol

Abstract

Introduction & objectives Previous research in PR has focussed on duration and location of courses, and models of exercise therapy. In order to meet a commissioning adherence target for 2009–2010, the Bristol community PR team modified stand alone static programmes (SP) (6 week) seeing 150 people per year to add in a continuous rolling programme (CRP) (2–4 new patients start every week attending 6 weeks) with the aim of improving adherence to programmes. The objective of this study was to examine if the outcomes of a CRP were as effective as the SP.

Method Retrospective analysis of outcome data for year 2009–2010 for improvement in 6 min walk test (m), change in Chronic Respiratory Disease Questionnaire (CRDQ), and attendance. Patients were offered a choice of programme at their initial clinic assessment.

Results Results for the two groups are shown in Abstract P47 Table 1. There were no significant differences between groups at baseline. The CRP had 55 (174%) more patients complete the programme throughout the year. There was no significant difference between groups for improvement in walking distance, attendance or CRDQ-D, CRDQ-F or CRDQ-EF. There was a significant improvement in the CRDQ-M in the CRP group.

Abstract P47 Table 1

Comparison data for static and rolling programmes 2009–2010

Conclusion This audit shows that the outcomes for a CRP are as good as SP and can be used as an effective method of delivering PR. Both groups require the same amount of staff time; however the CRP saw more patients and had more completers. This may be as cohorts of COPD patients often lose members which can reduce SP's by up to 33%. Within a CRP as patients drop out, new patients can be started keeping the cohort at a set level, thus allowing more patients to be seen. There appears to be a positive effect on CRDQ mastery with patients scoring significantly higher on this in the CRP. This may be an effect of patients who have attended for a while taking on the role as ‘experienced buddy’ helping the naive patient (Heisler 2009), however further research to investigate this is warranted.

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