Implementation of physical activity programs after COPD hospitalizations: Lessons from a randomized study

Roberto P Benzo, Marnie Wetzstein, Pamela Neuenfeldt, Charlene McEvoy

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45% male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1%) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39%), the perception of "being too ill or frail or disabled" (24%), the perception of being "too busy or having too much to do" (11%), distance or the need of travel (11%), commitment issues (7%), comorbidities (6%), and lack of social support (2%). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.

Original languageEnglish (US)
Pages (from-to)5-10
Number of pages6
JournalChronic Respiratory Disease
Volume12
Issue number1
DOIs
StatePublished - Feb 24 2015

Fingerprint

Chronic Obstructive Pulmonary Disease
Hospitalization
Rehabilitation
Exercise
Lung
Disease Progression
Patient Participation
Patient Preference
Forced Expiratory Volume
Social Support
Dyspnea
Comorbidity
Guidelines

Keywords

  • COPD exacerbations
  • emphysema exercise
  • palliative care
  • pulmonary rehabilitation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Implementation of physical activity programs after COPD hospitalizations : Lessons from a randomized study. / Benzo, Roberto P; Wetzstein, Marnie; Neuenfeldt, Pamela; McEvoy, Charlene.

In: Chronic Respiratory Disease, Vol. 12, No. 1, 24.02.2015, p. 5-10.

Research output: Contribution to journalArticle

Benzo, Roberto P ; Wetzstein, Marnie ; Neuenfeldt, Pamela ; McEvoy, Charlene. / Implementation of physical activity programs after COPD hospitalizations : Lessons from a randomized study. In: Chronic Respiratory Disease. 2015 ; Vol. 12, No. 1. pp. 5-10.
@article{096398c8584949c68918426f22fb039f,
title = "Implementation of physical activity programs after COPD hospitalizations: Lessons from a randomized study",
abstract = "Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45{\%} male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1{\%}) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39{\%}), the perception of {"}being too ill or frail or disabled{"} (24{\%}), the perception of being {"}too busy or having too much to do{"} (11{\%}), distance or the need of travel (11{\%}), commitment issues (7{\%}), comorbidities (6{\%}), and lack of social support (2{\%}). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.",
keywords = "COPD exacerbations, emphysema exercise, palliative care, pulmonary rehabilitation",
author = "Benzo, {Roberto P} and Marnie Wetzstein and Pamela Neuenfeldt and Charlene McEvoy",
year = "2015",
month = "2",
day = "24",
doi = "10.1177/1479972314562208",
language = "English (US)",
volume = "12",
pages = "5--10",
journal = "Chronic Respiratory Disease",
issn = "1479-9723",
publisher = "SAGE Publications Ltd",
number = "1",

}

TY - JOUR

T1 - Implementation of physical activity programs after COPD hospitalizations

T2 - Lessons from a randomized study

AU - Benzo, Roberto P

AU - Wetzstein, Marnie

AU - Neuenfeldt, Pamela

AU - McEvoy, Charlene

PY - 2015/2/24

Y1 - 2015/2/24

N2 - Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45% male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1%) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39%), the perception of "being too ill or frail or disabled" (24%), the perception of being "too busy or having too much to do" (11%), distance or the need of travel (11%), commitment issues (7%), comorbidities (6%), and lack of social support (2%). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.

AB - Pulmonary rehabilitation (PR), following an acute exacerbation of chronic obstructive pulmonary disease (COPD), has been found effective in some studies in reducing readmission rates as and has recently been recommended by the PR guidelines. However, very recent reports suggested that PR is not feasible after a hospital admission for a COPD exacerbation. The objective of this study is to investigate the knowledge gap on the underlying reasons for nonparticipation in PR in the posthospitalization period. We qualitatively analyzed the responses of 531 patients hospitalized for a COPD exacerbation who were not interested in participating in either PR (home or center based) or physical activity monitoring program after being discharged from the hospital. The responses were coded thematically, and independent reviewers compiled the raw data into themes. The characteristics of the 531 subjects (45% male) who declined the intervention are as follows: age was 70 ± 10 years, mean forced expiratory volume in one second (FEV1%) predicted 40 ± 16, and age, dyspnea, and airflow obstruction index 6.0 ± 1.6 (scale 0-10). The themes for not attending include lack of interest (39%), the perception of "being too ill or frail or disabled" (24%), the perception of being "too busy or having too much to do" (11%), distance or the need of travel (11%), commitment issues (7%), comorbidities (6%), and lack of social support (2%). We identified barriers for PR or just physical activity programs after a hospitalization that may affect implementation of such programs. Implementing posthospitalizations program in COPD may require patient engagement and mindful and compassionate professionals who may individualize program components to focus specific deficits and particularly patients' preferences.

KW - COPD exacerbations

KW - emphysema exercise

KW - palliative care

KW - pulmonary rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=84921483682&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921483682&partnerID=8YFLogxK

U2 - 10.1177/1479972314562208

DO - 10.1177/1479972314562208

M3 - Article

C2 - 25511306

AN - SCOPUS:84921483682

VL - 12

SP - 5

EP - 10

JO - Chronic Respiratory Disease

JF - Chronic Respiratory Disease

SN - 1479-9723

IS - 1

ER -