Article Text


Pulmonary rehabilitation: a challenging exercise?
P148 The adaptation and evaluation of the living well with COPD programme for pulmonary rehabilitation
  1. D Earley1,
  2. J MacMahon2,
  3. J Bourbeau3,
  4. J M Bradley1,
  5. B O'Neill1
  1. 1Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, Northern Ireland
  2. 2Department of Respiratory Medicine, Belfast City Hospital, Belfast, Northern Ireland
  3. 3Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Centre, Montreal, Canada


Introduction Mechanisms and materials to support the delivery of the education component of pulmonary rehabilitation are not widely available. The aim of this study was to adapt the Living Well with COPD (LWWCOPD) programme for embedding in pulmonary rehabilitation and to conduct a process and outcome evaluation.

Methods Adaptation: Modifications to the LWWCOPD programme were informed by focus groups, current practice, relevant research and guidelines, and in collaboration with the authors of the LWWCOPD programme. The study used a cohort before-after design which incorporated the principles of a process evaluation. Evaluation: Sites administered their usual pulmonary rehabilitation programme with the exception of the LWWCOPD programme for pulmonary rehabilitation to deliver the education component. Health professionals and patients completed evaluation questionnaires to assess their acceptance. Patients completed the Understanding COPD (UCOPD) questionnaire and the Bristol COPD Knowledge Questionnaire before and after pulmonary rehabilitation. Analysis: Feedback and comments on the programme were collated and categorised. Changes in the UCOPD questionnaire and BCKQ were examined using paired t-tests.

Results Adaptation: Amendments to the LWWCOPD programme included reducing the number and length of education sessions, incorporating additional information/techniques, materials to link the education and exercise sessions and a COPD action plan. Evaluation: 25 health professionals and 57 patients with COPD from eleven pulmonary rehabilitation programmes evaluated the LWWCOPD for pulmonary rehabilitation. The mean (SD) duration of the education sessions was 41 (9) min. The health professionals felt that the education sessions were either excellent (n=16/65, 25%) or good (n=40/65, 62%), and that they were comprehensive, evidence-based and utilised a good combination of teaching strategies for example, “Easy to follow and deliver”. They reported that the programme would require modification for non-COPD patients. Patients commented on improved knowledge and self-efficacy, peer support and relevant content for example, “Better understanding of action to be taken”. They requested supplementary information for family members. The UCOPD questionnaire and the BCKQ improved significantly: mean change (95% CI): UCOPD questionnaire: 26.8 (21.7 to 31.8)%, BCKQ: 10.6 (6.9 to 14.4)%.

Conclusion The LWWCOPD programme for pulmonary rehabilitation is a feasible, effective and versatile way to deliver the education component of COPD pulmonary rehabilitation.

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