An Implementation Trial to Improve Access to Pulmonary Rehabilitation in People With COPD

Summary

People with chronic obstructive pulmonary disease (COPD) experience distressing breathlessness and high health care utilisation. There is compelling evidence that pulmonary rehabilitation improves symptoms and reduces hospitalisation, but is delivered to \<10% of patients who would benefit. The investigators developed a low cost model of pulmonary rehabilitation that can be delivered entirely at home. The HomeBase model had equivalent outcomes to centre-based pulmonary rehabilitation in a phase II efficacy trial, with higher completion rates. The investigators hypothesise that a patient centred model offering a choice between home or centre-based pulmonary rehabilitation may increase program completion rates, with improved outcomes for patients and the health system.

This is a cluster randomised implementation trial investigating whether offering a choice of home or centre-based pulmonary rehabilitation can reduce hospitalisation, improve pulmonary rehabilitation completion and enhance patient outcomes in people with COPD. 14 pulmonary rehabilitation programs located across Australia will each recruit 35 people with COPD. Intervention centres: People with COPD will be offered the choice of centre-based pulmonary rehabilitation or the HomeBase model. Comparison centres: Only the existing centre-based model will be offered. The primary outcome is all cause, non-elective hospitalisation at 12 months. Other outcomes are symptoms, exercise capacity and quality of life at 8 weeks and 12 months; and health care costs at 12 months for full economic evaluation.

Conditions

• Chronic Obstructive Pulmonary Disease

Interventions

BEHAVIORAL

Choice of home-based or centre-based pulmonary rehabilitation

Participants will be offered the choice of HomeBase, a home-based pulmonary rehabilitation program, or the traditional centre-based pulmonary rehabilitation program.

BEHAVIORAL

Centre-based pulmonary rehabilitation

Participants will be offered a traditional centre-based pulmonary rehabilitation program

Sponsors & Collaborators

• Institute for Breathing and Sleep, Australia

  collaborator OTHER

• University of Melbourne

  collaborator OTHER

• La Trobe University

  collaborator OTHER

• Thoracic Society of Australia and New Zealand

  collaborator UNKNOWN

• Lung Foundation Australia

  collaborator UNKNOWN

• Monash University

  lead OTHER

Principal Investigators

• Anne Holland · Monash University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-03-01

Primary Completion

2026-02-28

Completion

2026-02-28

Countries

• Australia

Study Locations