RT Journal Article
SR Electronic
T1 Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e013682
DO 10.1136/bmjopen-2016-013682
VO 7
IS 3
A1 Emma Chaplin
A1 Stacey Hewitt
A1 Lindsay Apps
A1 John Bankart
A1 Ruth Pulikottil-Jacob
A1 Sally Boyce
A1 Mike Morgan
A1 Johanna Williams
A1 Sally Singh
YR 2017
UL http://bmjopen.bmj.com/content/7/3/e013682.abstract
AB Objectives The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR.Design Randomised controlled feasibility trial.Setting Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes. Patients randomised to conventional rehabilitation started the programme according to the standard care at their referred site on the next available date.Participants 103 patients were recruited to the study and randomised: 52 to conventional rehabilitation (mean (±SD) age 66 (±8) years, Medical Research Council (MRC) 3 (IQR2–4)); 51 to the web arm (mean (±SD) age 66 (±10) years, MRC 3 (IQR2–4)). Participants had to be willing to participate in either arm of the trial, have internet access and be web literate.Interventions Patients randomised to the web-based programme worked through the website, exercising and recording their progress as well as reading educational material. Conventional PR consisted of twice weekly, 2 hourly sessions (an hour for exercise training and an hour for education).Outcome measures Recruitment rates, eligibility, patient preference and dropout and completion rates for both programmes were collected. Standard outcomes for a PR assessment including measures of exercise capacity and quality of life questionnaires were also evaluated.Results A statistically significant improvement (p≤0.01) was observed within each group in the endurance shuttle walk test (WEB: mean change 189±211.1; PR classes: mean change 184.5±247.4 s) and Chronic Respiratory disease Questionnaire-Dyspnoea (CRQ-D; WEB: mean change 0.7±1.2; PR classes: mean change 0.8±1.0). However, there were no significant differences between the groups in any outcome. Dropout rates were higher in the web-based programme (57% vs 23%).Conclusions An interactive web-based PR programme is feasible and acceptable when compared with conventional PR. Future trials maybe around choice-based PR programmes for select patients enabling stratification of patient care.Trial registration number ISRCTN03142263; Results.