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P280 Pulmonary rehabilitation (PR) for interstitial lung disease (ILD). do patients’ perceptions match functional outcomes?
  1. L Stanley,
  2. C Cobbett,
  3. E Morris,
  4. D Gibson,
  5. SV Fletcher
  1. University Hospital Southampton NHS Foundation Trust, Southampton, UK

Abstract

Introduction ILD refers to a group of fibrotic lung conditions that differ in terms of treatment, prognosis and association. The NICE quality statement (2015) supports PR for patients with IPF, the most common form of ILD. There is no clear guidance for delivery of PR to ILD patients, so current practice is to extrapolate from the benefits of PR in COPD (Spruit et al, 2013), despite the differing pathophysiology.

Aim The focus of the study was to observe the patients’ perceptions of a modified ILD PR programme against functional and health related quantitative measures.

Methods Patients were recruited to the program either by self-referral or by ILD clinicians. Seven participants were recruited. The 6-week PR program consisted of 60 minutes exercise and 30 minutes education with the emphasis on strength training over endurance. Focus group interviews were used to collect qualitative data and analysed using an inductive approach utiilising thematic analysis as a method.

Results 7 patients completed the programme (5M:2F, mean age 73.4). Initial qualitative analysis demonstrates psychological benefit from the sharing of disease experiences, prioritising exercise as a means of management, empowerment and understanding. 6MWT and Kings Brief ILD questionnaire showed no significant change pre and post PR, see Table 1. These quantitative results do not reflect patient perceptions of improved functional status.

Conclusion Patients perceptions were positive regarding the content and impact it had on their education needs concerning their disease. The predominant perceived benefit was that of the comradery found in sharing experiences with other ILD patients. No firm conclusions can be drawn from this study regarding the effectiveness of PR for patients with ILD due to small numbers. It is unclear whether the tools used to assess functional and health measures are suitable to detect changes in outcomes post PR or whether the effects of an ILD PR programme are predominantly that of disease management and education, explaining the disparity observed between quantitative and qualitative outcomes. Further appropriately powered controlled studies could examine the impact of PR and in particular that of PR education specifically for ILD patients, as supported by Holland et al. (2015).

Abstract P280 Table 1

Mean differences in pre and post scores for 6MWD and Kings ILD questionnaire.

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