Multimorbidity rehabilitation in chronic disease: general rehabilitation compared to usual care

Not Applicable

Completed

• Conditions: Multimorbidity; Chronic disease; Chronic obstructive pulmonary disease; Bronchiectasis; Chronic asthma; Chronic heart failure; Coronary artery disease; Ischemic heart disease; Diabetes; Depression

• Registration Number: ACTRN12614001187639
• Lead Sponsor: Dr Elizabeth Skinner

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2014-11-12
• Last Update Posted: 13 January 2020

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 16

Inclusion Criteria

Adult patients (aged > 18) will be eligible to be enrolled if they have a physician diagnosis of two or more chronic conditions for which rehabilitation is indicated (as listed in the target conditions):
Chronic obstructive pulmonary disease
-Bronchiectasis
-Chronic asthma
-Chronic heart failure
-Coronary artery disease
-Ischaemic heart disease
- Diabetes
- Chronic kidney disease
- Depression or anxiety
- New diagnosis of cancer in past 5 years
- Stroke and transient ischaemic attack
- Peripheral vascular disease
- Parkinson's disease
- Multiple sclerosis
- Chronic liver disease

Exclusion Criteria

- Unable to walk > 50 metres;
- Severe cognitive impairment, psychiatric or intellectual disability which would limit ability to participate in a class with distant supervision or ability to complete outcome measures (defined as MMSE <= 18 points);
- Pulmonary hypertension with recent history of dizziness or syncope on exertion (must have medical clearance if mean pulmonary artery pressure > 50 mm Hg); or acute pulmonary embolus;
- Interstitial lung disease;
- Unstable cardiovascular disease (e.g. unstable angina, uncontrolled arrhythmia, NYH Class 4 CHF; uncontrolled hypertension, diastolic pressure > 95 mm Hg);
- Absolute contraindications to exercise (e.g. severe orthopaedic/neurological deficit; severe uncontrolled pain; surgical or medical (including active transmissible infectious disease) restrictions to mobilisation/rehabilitation e.g. diabetic foot; severe ischaemic vascular disease; advanced neuropathy/retinopathy) which would compromise the ability to safely exercise;
- People already participating in a structured exercise rehabilitation program from a community or external provider;
- Uncontrolled diabetes;
- Uncontrolled epilepsy or seizures;
- Extensive brain, skeletal or visceral metastases (confirmed cancer diagnosis);
- Life expectancy considered to be less than 12 months;
- Known thrombocytopaenia (<50×109/l) or severe neutropenia (neutropenia defined as absolute neutrophil count < 500/microL; profound neutropenia defined as ANL < 100 neutrophils/mm3, Freifeld et al., 2010);
- Room air desaturation at rest < 85%;
- Abnormal and untreated moderate anaemia (80-109 g/L);
- Pregnant women.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change in functional exercise capacity (as measured by the 6-minute walk test) <br>[Completion of rehabilitation program or usual care (eight weeks following commencement) <br>]

Secondary Outcome Measures

Name	Time	Method
Functional activities of daily living (as measured by the Katz ADL index)[Completion of rehabilitation or usual care (8 weeks following recruitment)];Health-related quality of life (as measured by the SF-36, AQoL-4D, EQ-5D-5L)[Completion of rehabilitation or usual care (8 weeks following recruitment)];Participant daily diary including hospital admissions and medical consultations)[Completion of rehabilitation or usual care (8 weeks following recruitment)];Resource utilization (measured from the diary completed by participants, calculating costs of GP appointments, hospitalisations)[Completion of rehabilitation or usual care (8 weeks following recruitment)];Catastrophic health events (calculated from diary); for example myocardial infarction, stroke, diabetic coma.[Completion of rehabilitation or usual care (8 weeks following recruitment)]