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一项针对慢性阻塞性肺疾病(COPD)的活动应对与教育自我管理计划——SPACE for COPD(C)——在初级保健中的应用:一项实用试验方案。

A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial.

作者信息

Bourne Claire LA, Kanabar Pratiksha, Mitchell Katy, Schreder Sally, Houchen-Wolloff Linzy, Bankart M John G, Apps Lindsay, Hewitt Stacey, Harvey-Dunstan Theresa, Singh Sally J

机构信息

Collaboration and Leadership for Applied Health Research and Care-East Midlands, Centre of Exercise and Rehabilitation Science, Respiratory Biomedical Research Unit, Glenfield hospital, Groby Road, Leicester, Leicestershire, UK.

Department of Primary Care and Health Sciences, Keele University, Keele, UK.

出版信息

BMJ Open. 2017 Jul 10;7(7):e014463. doi: 10.1136/bmjopen-2016-014463.

Abstract

INTRODUCTION

National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention.

METHODS AND ANALYSIS

A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically.

ETHICS AND DISSEMINATION

The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, via the Collaboration and Leadership in Applied Health Research and Care and through social media.

TRIAL REGISTRATION

ISRCTN17942821; pre-results.

摘要

引言

慢性阻塞性肺疾病(COPD)的国家指南建议为患者提供自我管理支持。我们机构制定了一项标准化的、基于手册的、有支持的自我管理计划:COPD活动应对与教育自我管理计划(SPACE for COPD(C))。SPACE之前由研究人员以一对一的方式在COPD患者中进行了试点。与利益相关者的讨论突出表明,人们对在初级保健环境中由医疗保健专业人员(HCPs)推动的基于小组的自我管理计划来实施SPACE for COPD(C)干预有着浓厚兴趣。本研究的目的是探讨由HCPs实施和支持该干预的可行性、可接受性和有效性,并研究基于小组的SPACE for COPD(C)实施方式,在持续支持下,是否能改善COPD患者在接受SPACE for COPD(C)干预后的结局。

方法与分析

将进行一项前瞻性、多中心、单盲随机对照试验(RCT),并在6个月和9个月时进行随访。参与者将被随机分配到对照组(常规护理)或干预组(为期5个月、共六节的基于小组的SPACE for COPD(C)自我管理计划)。主要结局是6个月时COPD评估测试的变化。将与实施干预的HCPs进行一次讨论会议,以讨论并深入了解在实际实施干预过程中的任何潜在促进因素/障碍。此外,我们将与干预参与者进行半结构化焦点小组讨论,以了解可行性和可接受性。所有定性数据将进行主题分析。

伦理与传播

该项目已获得南汉普郡B研究伦理委员会的批准意见,伦理委员会参考编号:14/SC/1169,并获得莱斯特大学医院国民保健服务信托基金的全面研发批准:152408。研究结果将通过适当的同行评审期刊、国内和国际呼吸/物理治疗会议、通过应用健康研究与护理合作与领导力以及通过社交媒体进行传播。

试验注册

ISRCTN17942821;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44d3/5734249/d32e8726bdd9/bmjopen-2016-014463f01.jpg

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