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The effectiveness of a structured education pulmonary rehabilitation programme for improving the health status of people with moderate and severe chronic obstructive pulmonary disease in primary care: the PRINCE cluster randomised trial
  1. Dympna Casey1,
  2. Kathy Murphy1,
  3. Declan Devane1,
  4. Adeline Cooney1,
  5. Bernard McCarthy1,
  6. Lorraine Mee1,
  7. John Newell2,
  8. Eamon O'Shea3,
  9. Carl Scarrott4,
  10. Paddy Gillespie3,
  11. Collette Kirwan1,
  12. Andrew W Murphy5
  1. 1School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
  2. 2HRB Clinical Research Facility and School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
  3. 3School of Business & Economics, National University of Ireland, Galway, Ireland
  4. 4Statistics Mathematic and Statistics Department, University of Canterbury, Christchurch, New Zealand
  5. 5Department of General Practice, National University of Ireland, Galway, Ireland
  1. Correspondence to Dr Dympna Casey, School of Nursing & Midwifery, National University of Ireland, Galway, Ireland; dympna.casey{at}nuigalway.ie

Abstract

Objective To evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).

Design Two-arm, cluster randomised controlled trial.

Setting 32 general practices in the Republic of Ireland.

Participants 350 participants with a diagnosis of moderate or severe COPD.

Intervention Experimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.

Main outcome measure Health status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12–14 weeks postcompletion of the programme.

Results Participants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.

Conclusions A primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.

Trial registration ISRCTN52403063.

  • Pulmonary Rehabilitation
  • Exercise

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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