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S11 Feasibility of a web-based self-management programme, as a ‘bridge’ to starting pulmonary rehabilitation, for individuals hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD)
  1. L Houchen-Wolloff1,2,
  2. M Orme1,
  3. L Clinch1,
  4. N Gardiner1,
  5. S Singh1,2
  1. 1NIHR Leicester Biomedical Research Centre- Respiratory, Leicester, UK
  2. 2University of Leicester, Leicester, UK

Abstract

Introduction and objectives Hospital admissions due to AECOPD are costly to the individual and the health service. Pulmonary Rehabilitation (PR) is a package of education and exercise, known to reduce hospital readmissions when delivered after hospitalisation. Despite these benefits, the completion of PR following hospitalisation is <10%1 and there is a need for strategies which may act as a ‘bridge’ to PR. A web-based platform of the SPACE for COPD© self-management programme has shown promising results in stable COPD.2

The primary aim of this study was to assess the feasibility of the web-based programme for individuals hospitalised with an AECOPD.

Methods Eligible patients had confirmed COPD, were web-literate and had an email address. All patients were consented during their hospitalisation and received access to the website for 12 months following discharge, in addition to usual care. The programme facilitates patients to better understand and manage their condition through education and home-based exercises.

The primary outcome was the proportion of screened patients consenting to the programme. We also collected web usage statistics and PR uptake at 6 months.

Results 2080 patients were screened for eligibility between May 2015–Sep 2017 of which 100 patients (71.2±9.3 years, 55% male, FEV1/FVC ratio 0.46±0.14, 50.2±31.0 pack years) were recruited (4.8% of those screened). The main reason for ineligibility was lack of web-literacy. 18% had completed the web programme by 6 months, with others still registered on the programme (27%) and over half not registering (55%). Of those accepting a referral to PR on discharge (57%), 19% completed the programme.

Conclusion Based on the challenges to recruit, retain and engage participants in the web-based self-management programme, it is not a feasible approach to roll out widely. However, for patients able to engage with such an intervention, the completion of PR was double the previous audit estimate1. Therefore, with further refinement, web-based strategies may be a viable stepping stone to PR. Identifying those patients most likely to benefit from web-based programmes is needed.

References

  1. Jones, et al. Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: Referrals, uptake and adherence. Thorax2013;69(2):181–2.

  2. Chaplin, et al. Interactive web-based pulmonary rehabilitation programme: A randomised controlled feasibility trial. BMJ Open2017;7:e013682.

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