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Clinical Trial
. 2019 Mar 12:14:631-643.
doi: 10.2147/COPD.S188731. eCollection 2019.

Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial

Patrick White  1 , Gill Gilworth  1 , Simon Lewin  2   3 , Lauren Hogg  4 , Rachel Tuffnell  5 , Stephanie J C Taylor  6 , Nicholas S Hopkinson  7 , Nicholas Hart  8 , Sally J Singh  9 , Alison J Wright  10
Affiliations
Clinical Trial

Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial

Patrick White et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: This study was designed to evaluate the feasibility of a cluster randomized controlled trial to test the efficacy of lay health workers (LHWs) in improving the uptake and completion of pulmonary rehabilitation (PR) in the treatment of COPD.

Materials and methods: LHWs, trained in confidentiality, role boundaries, and behavior change techniques, supported patients newly referred for PR. Interactions between LHWs and participants were recorded with smartphones. Outcomes were recruitment and retention rates of LHWs, questionnaire and interview-evaluated acceptability and analysis of intervention fidelity.

Results: Forty (36%) of 110 PR-experienced COPD patients applied to become LHWs. Twenty (18%) were selected for training. Twelve (11%) supported patients. Sixty-six COPD patients referred for PR received the intervention (5.5 participants per LHW). Ten LHWs were retained to the end of the study. Seventy-three percent of supported patients were satisfied or very satisfied with the intervention. LHWs delivered the intervention with appropriate style and variable fidelity. LHWs would welcome more intensive training. Based on this proof of concept, a cluster randomized controlled trial of an LHW intervention to improve uptake and completion of PR is feasible.

Conclusion: PR-experienced COPD patients can be recruited, trained, and retained as LHWs to support participation in PR, and can deliver the intervention. Participant COPD patients found the intervention acceptable. A cluster randomized controlled clinical trial is feasible.

Keywords: completion; intervention fidelity; recruitment; retention; uptake.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Recruitment flowchart. Abbreviations: LHWs, lay health workers; PR, pulmonary rehabilitation.
None
See this image and copyright information in PMC

References

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