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Pulmonary rehabilitation
P50 Facilitation of continued exercise via patient volunteers with chronic obstructive pulmonary disease (COPD) following a pulmonary rehabilitation programme: a feasibility study
  1. C A Langley-Johnson1,
  2. E Jenkin1,
  3. C A E Dyer2,
  4. K Gruffydd-Jones3,
  5. N Harris4,
  6. M Reed5,
  7. G Taylor5
  1. 1Wiltshire PCT, Chippenham, UK
  2. 2Royal United Hospital, Bath, UK
  3. 3Box Surgery, Chippenham, UK
  4. 4Bath Institute of Medical Engineering, Bath, UK
  5. 5BATH University, Bath, UK

Abstract

Introduction After pulmonary rehabilitation activity levels gradually decline, on average, back to baseline over 12–18 months. The NHS has highlighted the value of peer support for patients with chronic disease, but this has not been fully evaluated in patients with COPD. Therefore we designed an observational study with the aim of exploring and assessing an exercise maintenance programme with peer volunteer support over a 6-month period, in order to inform a future large-scale study.

Methods Patients were recruited from a 7-week outpatient community pulmonary rehabilitation programme. Six peer volunteers with COPD were trained and allocated up to six patients each. A fortnightly exercise maintenance programme was set up in one locality led by a physiotherapist & assistant. This was supported by a programme of home-based exercise, goal setting and feedback on activity levels. Peer volunteers met with their groups each month to encourage individual activity. The primary outcomes were participation levels and attendance rates; secondary outcomes were activity levels and health status. Qualitative interviews demonstrated the individual variance in exercise habits and motivations see Abstract P50 Table 1.

Results There were 91 potential recruits who completed rehabilitation (13 didn't meet criteria, six became unwell). 37 refused to participate, citing reasons such as poor health, no difficulty in exercising or problems travelling to the centre. Of the 35 that agreed to participate, the attendance rate at exercise was 70%, and 30 completed the 6-month programme. In this group Shuttle Walking Test distances were maintained at 6 months (mean 313.2 m post-rehabilitation compared with 317.8 m at 6 months, p=NS), and Chronic Respiratory Disease Questionnaire scores were also maintained. Qualitative analysis supported the concept of peer volunteers, while many individuals wanted flexibility and access to a range of activity programmes.

Conclusions This study suggests that maintenance programmes need to be individually tailored rather than prescriptive, in order to maximise uptake and meet the challenges posed by exacerbations. The role of peer volunteers in promoting activity is supported by the qualitative analysis, while exercise classes may help those who wish to attend.

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