School of Nursing and Midwifery, National University of Ireland, , Galway, Ireland.
Thorax. 2013 Oct;68(10):922-8. doi: 10.1136/thoraxjnl-2012-203103. Epub 2013 Jun 4.
To evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).
Two-arm, cluster randomised controlled trial.
32 general practices in the Republic of Ireland.
350 participants with a diagnosis of moderate or severe COPD.
Experimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.
Health status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12-14 weeks postcompletion of the programme.
Participants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.
A primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.
ISRCTN52403063.
评估结构化教育肺康复计划对慢性阻塞性肺疾病（COPD）患者健康状况的影响。
双臂、集群随机对照试验。
爱尔兰共和国的 32 家普通诊所。
350 名中度或重度 COPD 患者。
实验组接受由执业护士和物理治疗师提供的结构化教育肺康复计划。对照组接受常规护理。
基线和计划完成后 12-14 周时使用慢性呼吸系统问卷（CRQ）评估的健康状况。
分配到干预组的参与者的 CRQ 总分的平均变化具有统计学意义（调整后的平均差异（MD）为 1.11，95%置信区间（CI）为 0.35 至 1.87）。然而，CI 并不排除比预设的临床重要性更小的差异。干预后，分配到干预组的参与者的 CRQ 呼吸困难评分（调整后的 MD 为 0.49，95%CI 为 0.20 至 0.78）和 CRQ 体力评分（调整后的 MD 为 0.37，95%CI 为 0.14 至 0.60）也具有统计学意义更高。然而，CRQ 呼吸困难和 CRQ 体力亚量表的 CI 并不排除预设的临床重要性更小的差异。两组之间没有观察到其他具有统计学意义的差异。
基于初级保健的结构化教育肺康复计划是可行的，并且可以增加中度和重度 COPD 患者获得该计划的便利性。
ISRCTN52403063。
