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Implementing care coordination plus early rehabilitation in high-risk chronic obstructive pulmonary disease (COPD) patients in transition from hospital to primary care

Completed
Conditions
chronic obstructive pulmonary disease (COPD)
Respiratory - Chronic obstructive pulmonary disease
Public Health - Health service research
Registration Number
ACTRN12613001223729
Lead Sponsor
Dr Kylie Johnston
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
18
Inclusion Criteria

Patients admitted to hospital with a primary diagnosis of COPD; confirmation of COPD diagnosis by previous pulmonary function testing; length of admission at least 48 hours.

Exclusion Criteria

Potential participants are excluded if they have (a) insufficient English language or cognition to give informed consent; (b) been unable to walk during the previous 3 months.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Documentation of agreed patient goals and progress toward them using Flinders Program Problems and Goals Assessment, Flinders Program Care Plan, documentation of service facilitation<br>[End intervention (ie 1 month after hospital discharge)]
Secondary Outcome Measures
NameTimeMethod
Generation of Team Care Arrangement or other evidence of GP collaboration (documented by nurse practitioner)[End intervention (1 month post hospital discharge)];Assessment of pilot intervention feasibility (by examination of recruitment rate, retention rate, and resource capability)[End intervention (1 month post hospital discharge)];Assessment of pilot intervention fidelity (care coordination and early rehabilitation components delivered as planned; exercise sessions completed as planned by participant diary)[End intervention (1 month post hospital discharge)];Physical activity levels as documented by accelerometer and inclinometer worn for one week, compared with control group[one month after hospital discharge];Hospital readmissions compared with control group[one month after hospital discharge]
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