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  • Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol

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Respiratory medicine
Protocol
Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol
  1. Md Nazim Uzzaman1,
  2. Soo Chin Chan2,
  3. Ranita Hisham Shunmugam3,
  4. Julia Patrick Engkasan2,
  5. Dhiraj Agarwal4,
  6. G M Monsur Habib1,5,
  7. Nik Sherina Hanafi2,
  8. Tracy Jackson1,
  9. Paul Jebaraj6,
  10. Ee Ming Khoo2,
  11. Su May Liew2,
  12. Fatim Tahirah Mirza7,
  13. Hilary Pinnock1,
  14. Roberto A Rabinovich8,9
  1. 1NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
  2. 2Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  3. 3Library, University of Malaya, Kuala Lumpur, Malaysia
  4. 4KEM Hospital and Research Centre, Pune, India
  5. 5Community Respiratory Centre, Bangladesh Primary Care Respiratory Society, Khulna, Bangladesh
  6. 6Christian Medical College, Vellore, India
  7. 7Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia
  8. 8Respiratory Department, Royal Infirmary of Edinburgh, Edinburgh, UK
  9. 9Centre for Inflammation Research, QMRI, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Roberto A Rabinovich; roberto.rabinovich{at}ed.ac.uk

Abstract

Introduction Chronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care.

Methods and analysis We will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for ‘Chronic Respiratory Disease’ AND ‘Pulmonary Rehabilitation’ AND ‘Home-PR’, and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR?

Ethics and dissemination Research ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences.

PROSPERO registration number CRD42020220137.

  • chronic airways disease
  • respiratory medicine (see thoracic medicine)
  • rehabilitation medicine
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2021-050362

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    Footnotes

    • Contributors RAR and HP led the team (MNU, SCC, RHS, JPE, DA, GMMH, NSH, TJ, PJ, EMK, SML, FTM) who all contributed to the development of the protocol. MNU drafted the first version of the manuscript with support from SCC and DA, which was revised with contributions from all the authors. All authors have critically reviewed and approved the final manuscript.

    • Funding This research was commissioned by the UK National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE): 16/136/109, using UK Aid from the UK Government. The RESPIRE collaboration comprises the UK Grant holders, Partners and research teams as listed on the RESPIRE website (www.ed.ac.uk/usher/respire), including Harish Nair. TJ is part-funded by the NIHR RESPIRE. GMMH has an NIHR RESPIRE PhD studentship. MNU, DA, SML hold NIHR RESPIRE Fellowships. HP, RAR, EMK, SCC, JPE, NSH, SML are co-investigators of NIHR RESPIRE-funded PR feasibility studies in their respective Centres. RESPIRE is funded by the National Institute of Health Research using Official Development Assistance (ODA) funding.

    • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.

    • Competing interests GMMH owns a Pulmonary Rehabilitation clinic in Bangladesh. All other authors declare no competing interests.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.