The Effectiveness of Tele-pulmonary Rehabilitation Program on People With Chronic Obstructive Pulmonary Disease (COPD) After Hospitalization for Acute Exacerbation
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Six Minute Walk Test (6MWT)
研究概览
简要总结
Introduction: There are great impacts of chronic obstructive pulmonary disease (COPD) over healthcare and economic systems globally. Managing COPD stably in community is still a challenging topic due to its progressive nature, it is valuable to be studied with a view to improving the health status and quality of life in people with COPD and thus relieving the healthcare and economic burdens. Pulmonary rehabilitation (PR) was proven to be cost-effective with clinical benefits in optimizing quality of life, physical conditions and reducing hospital re-admissions rate in people with COPD. Traditionally, PR training was conducted under professional supervision in a face-to-face format. Community-based PR, like tele-rehabilitation, centre-based and homebased rehabilitation are emerging as an effective alternative to traditional PR. Promoting community-based rehabilitation is possibly one of the ways to engage people with chronic diseases in selfmanagement at their doorstep, which will help to tackle the escalating aging population and their heavy burden to the public healthcare system in Hong Kong.
Objectives: The objectives of this study are:
- To evaluate the clinical effectiveness of the newly developed tele-pulmonary rehabilitation program on people with COPD after hospitalized acute exacerbation,
- To explore participants' experience towards the program and develop a deeper understanding about the enablers and barriers faced by participants in joining the - tele-pulmonary rehabilitation program for quality assessment and improvement Methodology: Quasi-experimental design will be adopted in quantitative study, participants will join an eight-session tele-PR program in the intervention group, and participants will join the control group when pending for traditional out-patient based PR program. Purposive sampling will be adopted, participants should be clinically diagnosed COPD, able to participate in scheduled PR program and able to listen, speak, read and understand Chinese. Four domains of outcome measures will be collected, including participant profile, physical health status, health-related quality of life and healthcare resources utilization, for evaluation. Qualitative study with phenomenological approach will be adopted to discover participants' experience in the service. Semistructured, individual face-to-face in-depth interviews will be conducted once participants complete the tele-pulmonary rehabilitation program. Significance: This study will provide solid evidence on the effectiveness of tele-pulmonary rehabilitation program for people with COPD after hospitalized for acute exacerbation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinically diagnosed chronic obstructive pulmonary disease (therefore, with or without confirmation by previous spirometry), no limitation on GOLD stage for participants with previous spirometry; AND
- •Aged 18 or above, without limitation on sex, smoking history and medications using; AND
- •Able to participate in the scheduled pulmonary rehabilitation program; AND
- •Owning private electronic devices and Internet connection at
排除标准
- •With unstable medical conditions; OR
- •With major musculo-skeletal, neurological, psychiatric or cognitive disorders; OR
- •Refusal on clinical study.
研究组 & 干预措施
Intervention
Tele-pulmonary rehabilitation
干预措施: Tele-pulmonary rehabilitation (Behavioral)
Control
Usual care
结局指标
主要结局
Six Minute Walk Test (6MWT)
时间窗: Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure
The Six Minute Walk Test (6MWT) uses a standard 30-meter indoor hallway protocol (measurement tool) to evaluate functional exercise capacity. The unit of measure is the total distance walked in meters. Scores range from a theoretical minimum of 0 meters to an unlimited maximum based on functional ability; higher values represent a better outcome (greater exercise tolerance).
Saint George's Respiratory Questionnaire (Hong Kong Chinese version) (SGRQ-HK)
时间窗: Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure
The Saint George's Respiratory Questionnaire (Hong Kong Chinese version) (SGRQ-HK) is a disease-specific questionnaire (measurement tool) used to assess health-related quality of life. The unit of measure is the SGRQ total score (expressed as a points from 0 to 100). Scores range from a minimum of 0 to a maximum of 100; higher values mean a worse outcome (greater health impairment and lower quality of life).
Unplanned hospital re-admission rate
时间窗: Measure twice at 28-day and 3-month post-hospital discharge, independent to the intervention time-frame
The Unplanned Hospital Re-admission Rate uses electronic medical record audit logs to evaluate health resource utilization. It is a binary variable that 'Yes' or 'No' are the only options. Unplanned is referring to any unscheduled admissions via Emergency Department, the time frame was within 28 days and within 3 months of the last hospital discharge, the date of the latest hospital discharge is defined as day 0.
次要结局
- Modified Medical Research Council (mMRC) dyspnea scale(Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure)
- Dyspnoea-12 (Chinese version) (D-12-C)(Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure)
- Five-Time-Sit-To-Stand test (FTSTS)(Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure)
- Handgrip strength(Baseline measure within 3 days the participants are discharged from in-patient care; AND post-intervention measure at 8-week after baseline measure)
研究者
Mo Kim Chung
Advanced Practice Physiotherapist
North District Hospital