PT - JOURNAL ARTICLE AU - Anne E Holland AU - Ajay Mahal AU - Catherine J Hill AU - Annemarie L Lee AU - Angela T Burge AU - Narelle S Cox AU - Rosemary Moore AU - Caroline Nicolson AU - Paul O'Halloran AU - Aroub Lahham AU - Rebecca Gillies AU - Christine F McDonald TI - Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial AID - 10.1136/thoraxjnl-2016-208514 DP - 2017 Jan 01 TA - Thorax PG - 57--65 VI - 72 IP - 1 4099 - http://thorax.bmj.com/content/72/1/57.short 4100 - http://thorax.bmj.com/content/72/1/57.full SO - Thorax2017 Jan 01; 72 AB - Background Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor. We assessed whether home-based pulmonary rehabilitation, delivered using minimal resources, had equivalent outcomes to centre-based pulmonary rehabilitation.Methods A randomised controlled equivalence trial with 12 months follow-up. Participants with stable COPD were randomly assigned to receive 8 weeks of pulmonary rehabilitation by either the standard outpatient centre-based model, or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist. The primary outcome was change in 6 min walk distance (6MWD).Results We enrolled 166 participants to receive centre-based rehabilitation (n=86) or home-based rehabilitation (n=80). Intention-to-treat analysis confirmed non-inferiority of home-based rehabilitation for 6MWD at end-rehabilitation and the confidence interval (CI) did not rule out superiority (mean difference favouring home group 18.6 m, 95% CI −3.3 to 40.7). At 12 months the CI did not exclude inferiority (−5.1 m, −29.2 to 18.9). Between-group differences for dyspnoea-related quality of life did not rule out superiority of home-based rehabilitation at programme completion (1.6 points, −0.3 to 3.5) and groups were equivalent at 12 months (0.05 points, −2.0 to 2.1). The per-protocol analysis showed the same pattern of findings. Neither group maintained postrehabilitation gains at 12 months.Conclusions This home-based pulmonary rehabilitation model, delivered with minimal resources, produced short-term clinical outcomes that were equivalent to centre-based pulmonary rehabilitation. Neither model was effective in maintaining gains at 12 months. Home-based pulmonary rehabilitation could be considered for people with COPD who cannot access centre-based pulmonary rehabilitation.Trial registration number NCT01423227, clinicaltrials.gov.