TY - JOUR
T1 - Implementation of physical activity programs after COPD hospitalizations
T2 - Lessons from a randomized study
AU - Benzo, Roberto
AU - Wetzstein, Marnie
AU - Neuenfeldt, Pamela
AU - McEvoy, Charlene
N1 - Funding Information:
This work was supported by a grant (grant no: 1R01CA163293-01 to RB) from the National Heart, Lung and Blood Institute, National Institutes of Health, USA. Clinical trial registration no: NCT01058486; primary source of funding: NIH – NHLBI 5R01HL094680-05.
Publisher Copyright:
© The Author(s) 2014.
PY - 2015/2/24
Y1 - 2015/2/24
N2 - Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45% male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1%) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39%), the perception of "being too ill or frail or disabled" (24%), the perception of being "too busy or having too much to do" (11%), distance or the need of travel (11%), commitment issues (7%), comorbidities (6%), and lack of social support (2%). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.
AB - Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45% male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1%) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39%), the perception of "being too ill or frail or disabled" (24%), the perception of being "too busy or having too much to do" (11%), distance or the need of travel (11%), commitment issues (7%), comorbidities (6%), and lack of social support (2%). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.
KW - COPD exacerbations
KW - emphysema exercise
KW - palliative care
KW - pulmonary rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=84921483682&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921483682&partnerID=8YFLogxK
U2 - 10.1177/1479972314562208
DO - 10.1177/1479972314562208
M3 - Article
C2 - 25511306
AN - SCOPUS:84921483682
SN - 1479-9723
VL - 12
SP - 5
EP - 10
JO - Chronic respiratory disease
JF - Chronic respiratory disease
IS - 1
ER -