Benefits and Costs of Home-based Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease

Summary

Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease (COPD) which improves symptoms, reduces hospitalisation and lowers healthcare costs. However less than 1% of Australians with COPD receive pulmonary rehabilitation each year, due to poor access to programs and high levels of disability. This randomised controlled trial will examine the benefits and costs of a novel, entirely home-based pulmonary rehabilitation program for COPD. We hypothesise that home-based pulmonary rehabilitation can deliver equivalent clinical outcomes at lower cost than the centre-based program.

We will randomly allocate 144 people with COPD to undertake either standard pulmonary rehabilitation in a hospital setting, or a low-cost home-based program. Those who undertake pulmonary rehabilitation in the hospital setting will attend the hospital twice each week for eight weeks for supervised exercise training and education. People in the home pulmonary rehabilitation group will receive one home visit and weekly telephone calls for eight weeks, for supervision and mentoring of exercise and provision of education. We will compare the number of people who complete the program in each setting. We will also test whether the groups have similar results for the standard pulmonary rehabilitation outcomes of breathlessness, quality of life and exercise capacity, at the end of the program and 12 months later. We will compare health care costs and personal costs between groups after 12 months.

If home-based pulmonary rehabilitation can improve uptake of this important treatment, deliver good clinical outcomes and reduce costs this will have significant and long-lasting benefits for patients, the community and the health system

Conditions

• Chronic Obstructive Pulmonary Disease

Interventions

BEHAVIORAL

Home-based pulmonary rehabilitation

One home visit plus weekly telephone calls for 8 weeks

BEHAVIORAL

Hospital-based pulmonary rehabilitation

Standard twice-weekly 8-week outpatient pulmonary rehabilitation program

Sponsors & Collaborators

• The Alfred

  collaborator OTHER

• Austin Health

  collaborator OTHER_GOV

• Monash University

  collaborator OTHER

• La Trobe University

  lead OTHER

Principal Investigators

• Anne E Holland, PhD · La Trobe University, Alfred Health, Institute for Breathing and Sleep

• Christine F McDonald, PhD · Austin Health, Institute for Breathing and Sleep

• Ajay Mahal, PhD · Monash University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2011-10-31

Primary Completion

2015-05-31

Completion

2015-05-31

Countries

• Australia

Study Locations