Can Patients With COPD Assimilate Disease-Specific Information During an Acute Exacerbation?

Janaudis-Ferreira, Tânia; Carr, Sylvia Jocelyn; Harrison, Samantha; Gershon, Andrea S.; Milner, Siobhan C.; Carr, Sean; Fishbein, David; Goldstein, Roger

doi:10.1016/j.chest.2018.05.028

Cited by 11 publications

(11 citation statements)

References 33 publications

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“…It aims to achieve a proactive attitude towards their pathology, but its influence on clinical results has not been sufficiently investigated. This study has found that our educational program is similar in terms of educational results to programs carried out in other countries such as Canada or Sweden; 11 – 13 despite the fact that patients included in our study, had a recent diagnosis and had not received information previously about their disease. The domains of the questionnaire in which patients have the greatest IN are “Diet” and “Self-care”.…”

Section: Discussionsupporting

confidence: 62%

“…It has been used to evaluate respiratory rehabilitation programs, 10 in other types of educational programs for patients with COPD in outpatient clinics 11 , 12 or during hospital admissions. 13 This questionnaire has been previously validated 9 and translated into several languages including Spanish. 14 However, the LINQ has never been used to assess which COPD Characteristics are correlated with information needs (IN), nor how IN influence moderate COPD exacerbations or admissions due to exacerbations.…”

Section: Introductionmentioning

confidence: 99%

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<p>Information Needs in COPD After an Educational Programme: Influence in Exacerbations and Admissions</p>

Diago

Pérez-García

Fernández

et al. 2020

COPD

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Introduction Improving patients’ information needs (IN) may contribute to better control in COPD. This study analyses IN using Lung Information Needs Questionnaire (LINQ) following an educational intervention, evaluates how clinical characteristics modify IN, and studies high IN as a prognostic factor for COPD exacerbations and hospital admissions. Methods Cohort of 143 patients with initial diagnosis of COPD included in a structured educational program. Two months after completing the program, IN was assessed using LINQ. Correlations between IN and clinical variables of COPD and distribution of IN in different clinical groups were analyzed. Univariate and multivariate analysis was performed to determine influence of IN on exacerbations and COPD admissions over the following year. Results LINQ scored 6.3±2.9. There were no differences in LINQ scoring between different clinical groups, but LINQ score positively correlated with age (r=0.184, p=0.029). High IN was a predictor of COPD hospitalizations (HR 2.3 [95% CI 1.1–5.1] (p=0.029)) but not of less severe exacerbations (p=0.334). Conclusion IN was not associated with any clinical variables, but it correlated with age. High IN proved to be an independent predictor of admissions.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

<p>Information Needs in COPD After an Educational Programme: Influence in Exacerbations and Admissions</p>

Diago

Pérez-García

Fernández

et al. 2020

COPD

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“…The most used components in the interventions were aerobic training, strength training, breathing techniques and education and psychosocial support, either in isolation [19,25,27,30,32,41,45,47,48,52,54,55,58,59] or in combination [18, 20-24, 26, 28, 29, 31, 33-40, 42-44, 46, 49-51, 53, 56, 57], both of which are also common in pulmonary rehabilitation practice with patients with stable COPD [60]. Nevertheless, during AECOPD, patients present an increased airway and systemic inflammation that results in increased dyspnoea, cough and sputum volume and purulence, and further impairment of muscle strength, functionality and exercise tolerance and, hence, different characteristics and needs from those in the stable phase [1,61,62].…”

Section: Discussionmentioning

confidence: 99%

“…Quality assessment of the included studies with the Delphi List In total, 3569 patients with a mean age of 69.1 years and a mean FEV 1 of 39.4% predicted (data gathered from 35 studies, as seven of the included studies did not report the mean FEV 1 % pred) were enrolled in the included studies.Studies evaluated the effect of the applied intervention on patients' exercise capacity (n=23, ES range −1.8-5.0)[21,22,, muscle strength (n=11, ES −0.5-1.5)[26, 27, 36-38, 40-43, 45, 46], lung function (n=17, ES −3.0-1.4)[22, 24-26, 30, 32, 33, 37, 39, 40, 42, 46-51], functionality (n=7, ES −1.7-6.8) [31, 40, 41, 45, 46, 52, 53], physical activity levels (n=3, ES 1.2-2.6) [26, 41, 47], vital signs and peripheral oxygen saturation (n=10, ES −3.1-3.4) [24, 29, 31, 32, 36, 37, 39, 42, 48, 50], symptoms (n=26, ES −4.0-4.8) [20-25, 28, 29, 31-34, 36, 37, 42, 45-55], impact of disease (n=4, ES −5.1-0.9) [30, 31, 44, 49], disease severity (n=3, ES −4.7-−0.3) [22, 29, 31], HRQoL (n=25, ES −3.0-6.1) [18, 20-24, 26, 28-31, 33, 35, 36, 38, 39, 42, 46-48, 51, 55-58], length of stay (n=19, ES −0.8-0.9)[20, 22, 25, 26, 30, 36, 37, 40-43, 45, 46, 48, 49, 51-53, 56], new exacerbations (n=4, ES 0.1-1.0)[23,33,36,38], hospital readmissions (n=14, ES 0.1-1.8)[19,21,22,29,33,35,38,43,44,47,52,[56][57][58], and mortality (n=10, ES 0.1-1.2)[18,19,21,22,37,44,54,[56][57][58]. Additionally, studies also assessed patients' knowledge (n=4, ES −0.3-15.1)[21,47,56,59], satisfaction (n=4, ES 0.2-9.3)[47,…”

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confidence: 99%

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

et al. 2020

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This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 studies were included. Most studies were conducted in an inpatient setting (57%) and started the intervention 24–48 h after hospital admission (24%). Exercise training (71%), education and psychosocial support (57%) and breathing techniques (55%) were the most used components. Studies combining exercise with breathing techniques presented the larger effects on exercise capacity (weighted mean difference (WMD) −41.06, 95% CI −131.70–49.58) and health-related quality of life (WMD 16.07, 95% CI 10.29–21.84), and breathing techniques presented the larger effects on dyspnoea (WMD 1.90, 95% CI 0.53–3.27) and length of hospitalisation (effect size =0.15, 95% CI −0.28–0.57). A few minor adverse events were found.Pulmonary rehabilitation is a safe intervention during AECOPD. Exercise, breathing techniques, and education and psychosocial support seem to be the core components for implementing pulmonary rehabilitation during AECOPD. Studies may now focus on comparisons of optimal timings to start the intervention, total duration of the intervention, duration and frequency of sessions, and intensity for exercise prescription.

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“…Although the authors of this study concluded that the intervention was feasible, only 30% of the approached patients accepted participation, and retention at 2 weeks was only 52%. In a recent pilot randomized, controlled trial (27), where a brief education program (with no exercise…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study to Inform a More Acceptable Pulmonary Rehabilitation Program after Acute Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2019

Self Cite

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Rationale: Current international guidelines for prevention of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) recommend enrolment and participation in a pulmonary rehabilitation (PR) program within 4 weeks of hospital discharge. However, there is poor uptake of these programs as well as low adherence and completion rates. Objectives: The objectives of this study were to explore the views of patients and healthcare professionals (HCPs) on PR after AECOPD and how participation could be enhanced. Methods: A qualitative study was undertaken, and data were analyzed using deductive thematic analysis. A total of 13 patients who had experienced an AECOPD in the previous 6 months and 11 HCPs experienced in the management of COPD participated in face-to-face, semistructured interviews. Patients and HCPs were recruited from both rehabilitation and acute hospital settings. Results: Four main themes were identified: 1) uncertainty about timing of PR-most HCPs endorsed the professional guidelines that advocate for PR programs to begin within 4 weeks of an AECOPD; patients, however, varied drastically in their view of the ideal timing to start a PR program, anywhere from before an exacerbation (perhaps preventing one) and up to 6-8 weeks after exacerbation; 2) tailored and flexible manner to deliver PR programs with a gradual start-patients and HCPs talked about individually tailored programs with a gradual introduction of exercise and teaching sessions; some HCPs advocated allowing patients to pick and choose which elements would help them the most; 3) education for allpatients would like HCPs to be more informed and informative about the PR programs available in their neighborhoods, and HCPs focused on how they could educate patients about their disease and how better to manage it; and 4) logistical, disease-related, and psychological barriers-barriers to PR were discussed by both HCPs and patients; these fell into two categories: a) delivery issues (i.e., transportation and location of PR); and b) patient-specific issues (too sick or too well, high levels of anxiety). Conclusions: Our findings lay the foundation for the development of a flexible, stepped-care approach to delivering PR after AECOPD, which should be tailored according to the needs and preferences of the individual.

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Can Patients With COPD Assimilate Disease-Specific Information During an Acute Exacerbation?

Abstract: ClinicalTrials.gov; No.: NCT02321215; URL: www.clinicaltrials.gov.

Cited by 11 publications

References 33 publications

<p>Information Needs in COPD After an Educational Programme: Influence in Exacerbations and Admissions</p>

<p>Information Needs in COPD After an Educational Programme: Influence in Exacerbations and Admissions</p>

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

A Qualitative Study to Inform a More Acceptable Pulmonary Rehabilitation Program after Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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