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COMPAR-EU RCTs Web
Does early pulmonary rehabilitation reduce acute health-care utilization in COPD patients admitted with an exacerbation? A randomized controlled study
See more Setting of implementation: N/A Professionals delivering the intervention: N/A Targeted self-management behaviours: N/A
Components
Individual sessions
A single person receives the self-management support. Examples: self-guided actions (without the participation of any other person) during a clinical visit or within the context of a support or educational session
Face-to-face
Self-management support delivered in a face-to-face encounter between the providers and patients and/or caregivers.
See more Setting of implementation: Outpatient care (hospital) Professionals delivering the intervention: Educator Targeted self-management behaviours: Condition-specific behaviours, Early recognition of symptoms, Eating behaviours, Handling /managing emotions, Medication use and adherence, Physical activity /exercise
Components
Education (E)
Education (E)
Sharing information. This form of support consists in sharing of information about self-management topics like coping with symptoms, diet, exercise, medication, information about what other people are doing, and information about the disease itself, or about any other relevant aspects that could lead to improved self-management, and ultimately better health. This information can be told or distributed in printed materials like a folder or workbook, or via website or DVD.
Examples: Educational session on healthy eating for people with obesity, provision of a printed leaflet on the importance of foot care in diabetes, or a link to a website with information on chronic obstructive pulmonary disease care.
Action-based behavioural change techniques (AB)
Action-based behavioural change techniques (AB)
There are different action-based behavioural change techniques:
Enhancing problem-solving skills. This technique consists in teaching on how to analyse factors that influence your behaviour and provide you or help you to develop strategies to reduce or overcome barriers and/or support facilitators (e.g., not eating unhealthy foods when you feel depressed). Strategies include anticipation, self-treatment, resource utilization, and problem management. Ideally, there should be an initial plan, but this is not a requisite.
Example: Identification and attenuation of environmental barriers (e.g., no gym in the neighbourhood when one want to exercise) and facilitators (e.g., someone who keeps you company during exercise) to everyday physical activities.
Goal setting and action planning. This technique consists in encouraging you to set one or more achievable goals based on your needs and preferences. These goals may be behaviours (e.g., a consuming a healthy meal three times a day) or outcomes (e.g., less pain) and can be used as a starting point. The process usually involves the formulation of a detailed action plan, specifying what you would do and at least when and/or where you will do it. It could also include an assessment of your behaviours with your health care provider and a discussion of goals and the writing up of agreed-on action plans, including plans for emergency situations.
Examples of goals: achieving a daily walking distance of 2 km or a weight loss of some kilograms in x months with diet and exercise.
Emotional-based change techniques (EB)
Emotional-based change techniques (EB)
There are different emotional-based behavioural change techniques:
Stress and/or emotional management. This technique consists in helping you to understand the role of stress and emotions and teaching them to use different coping strategies to manage, for example, stress and painful emotions caused by your disease.
Examples: Mindfulness, exercise, stretching, listening to music, deep breathing, or meditation.
Coaching and motivational interviewing. This kind of support helps you to change behaviours by looking what’s important to you, and then offering support, taking into account your needs and preferences. One provider (healthcare professional, peer or lay person) is usually your coach. Motivational interviewing and counselling are included, as well as collaborative conversations with a practitioner, helping with motivation and commitment, minimizing resistance, and resolve ambivalence to change.
Examples: coaching sessions led by a nurse to ease the transition from hospital to home, or rehabilitation programs using coaching methods.
Individual sessions
A single person receives the self-management support. Examples: self-guided actions (without the participation of any other person) during a clinical visit or within the context of a support or educational session
Face-to-face
Self-management support delivered in a face-to-face encounter between the providers and patients and/or caregivers.
Outcomes measured in the study
Outcome | Measure | Tool |
---|---|---|
COPD symptoms (short term) | Dyspnea or breathlessness | Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index (BODE index) |
COPD symptoms (short term) | Dyspnea or breathlessness | Borg Rating of Perceived Exertion Scale (Borg RPE or BORG CR10) |
COPD symptoms (short term) | Dyspnea or breathlessness | Modified Medical Research Council (MMRC) |
Coping with the disease, including depression and anxiety | Anxiety | Hospital Anxiety and Depression Scale (HADS)-Anxiety subscale |
Coping with the disease, including depression and anxiety | Depression | Hospital Anxiety and Depression Scale (HADS) -depression subscale |
Number of emergency room visits and admissions | COPD-related hospital readmissions | N/A |
Number of emergency room visits and admissions | Hospital days (Lenght of stay) | N/A |
Physical activity / Muscle strenght | Exercise capacity | 6-min walking test (6MWT) |
Qualiy of life | Quality of life (specific-disease instruments) | N/A |
Qualiy of life | Quality of life (generic instruments) | N/A |
Qualiy of life | Quality of life (generic instruments) | N/A |
Patient characteristics
3.15 (+/- a standard deviation of 1.3)
Number of co-morbidities: N/A
Tool: N/A
Risk of Bias of this study
Outcome | Random sequence generation | Allocation concealment | Blinding performance | Blinding detection objective outcomes assessment | Attrition incomplete outcome | Incorrect statistical methods | Recruitment bias | Selective outcome reporting |
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COPD symptoms (short term) - Dyspnea or breathlessness | ||||||||
COPD symptoms (short term) - Dyspnea or breathlessness | ||||||||
COPD symptoms (short term) - Dyspnea or breathlessness | ||||||||
Coping with the disease, including depression and anxiety - Anxiety | ||||||||
Coping with the disease, including depression and anxiety - Depression | ||||||||
Number of emergency room visits and admissions - COPD-related hospital readmissions | ||||||||
Number of emergency room visits and admissions - Hospital days (Lenght of stay) | ||||||||
Physical activity / Muscle strenght - Exercise capacity | ||||||||
Qualiy of life - Quality of life (generic instruments) | ||||||||
Qualiy of life - Quality of life (generic instruments) | ||||||||
Qualiy of life - Quality of life (specific-disease instruments) |
Learn more about the intervention: Action-based and emotional-based behavioural techniques
Summary of findings | |
RCTs that also analysed this type of intervention | |
Related cost-effectiveness analysis |
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To learn more about the cost-effectiveness of self-management interventions check our section on the topic: Cost-effectiveness
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Related contextual analysis |
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To learn more about the contextual factors that can facilitate or hinder the implementation of a self-management intervention check our section on the topic: Contextual factors
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