Reflexive thematic analysis exploring stakeholder experiences of virtual pulmonary rehabilitation (VIPAR)

IntroductionTo enable greater availability of pulmonary rehabilitation (PR), video-conferencing technology was employed to link a community site to a standard outpatient PR service to deliver the programme closer to those with chronic respiratory disease. The service was called virtual pulmonary rehabilitation (VIPAR). To understand the experiences of those involved in this service, this study aimed to answer the question: How do the different stakeholders that interact with VIPAR experience the programme?MethodsFocus groups were conducted with people with chronic lung disease attending either the community or outpatient PR site, in addition to the staff involved in the running of the PR groups. A total of five focus groups were conducted. Reflexive thematic analysis was used to analyse the transcripts.ResultsParticipants who received VIPAR were positive regarding the programme and described the benefits of the service. Additionally, participants discussed the trade-off between convenience and relatedness. Staff described barriers to the service and solutions that could be employed to mitigate these, including greater training, organisation and understanding of risk.DiscussionUsing technology to increase the availability of PR is acceptable to the stakeholders involved, providing problems and organisational issues are resolved with training.

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Chronic respiratory disease and survival outcomes after extracorporeal membrane oxygenation

Respiratory Research ◽

10.1186/s12931-021-01796-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Tak Kyu Oh ◽

Hyoung-Won Cho ◽

Hun-Taek Lee ◽

In-Ae Song

Keyword(s):

Respiratory Failure ◽

Extracorporeal Membrane Oxygenation ◽

Lung Disease ◽

Respiratory Disease ◽

Chronic Respiratory Disease ◽

Newly Diagnosed ◽

Membrane Oxygenation ◽

Obstructive Sleep ◽

All Cause Mortality ◽

Ecmo Therapy

Abstract Background Quality of life following extracorporeal membrane oxygenation (ECMO) therapy is an important health issue. We aimed to describe the characteristics of patients who developed chronic respiratory disease (CRD) following ECMO therapy, and investigate the association between newly diagnosed post-ECMO CRDs and 5-year all-cause mortality among ECMO survivors. Methods We analyzed data from the National Health Insurance Service in South Korea. All adult patients who underwent ECMO therapy in the intensive care unit between 2006 and 2014 were included. ECMO survivors were defined as those who survived for 365 days after ECMO therapy. Chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease, lung cancer, lung disease due to external agents, obstructive sleep apnea, and lung tuberculosis were considered as CRDs. Results A total of 3055 ECMO survivors were included, and 345 (11.3%) were newly diagnosed with CRDs 365 days after ECMO therapy. The prevalence of asthma was the highest at 6.1% (185). In the multivariate logistic regression, ECMO survivors who underwent ECMO therapy for acute respiratory distress syndrome (ARDS) or respiratory failure had a 2.00-fold increase in post-ECMO CRD (95% confidence interval [CI]: 1.39 to 2.89; P < 0.001). In the multivariate Cox regression, newly diagnosed post-ECMO CRD was associated with a 1.47-fold (95% CI: 1.17 to 1.86; P = 0.001) higher 5-year all-cause mortality. Conclusions At 12 months after ECMO therapy, 11.3% of ECMO survivors were newly diagnosed with CRDs. Patients who underwent ECMO therapy for ARDS or respiratory failure were associated with a higher incidence of newly diagnosed post-ECMO CRD compared to those who underwent ECMO for other causes. Additionally, post-ECMO CRDs were associated with a higher 5-year all-cause mortality. Our results suggest that ECMO survivors with newly diagnosed post-ECMO CRD might be a high-risk group requiring dedicated interventions.

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The effect of pulmonary rehabilitation on physical performance and health related quality of life in patients with chronic lung disease

Respiratory Medicine ◽

10.1016/j.rmed.2021.106533 ◽

2021 ◽

pp. 106533

Author(s):

Myrian Vinan-Vega ◽

Barbara Mantilla ◽

Shengping Yang ◽

Kenneth Nugent

Keyword(s):

Quality Of Life ◽

Lung Disease ◽

Physical Performance ◽

Chronic Lung Disease ◽

Pulmonary Rehabilitation ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Myocardial Infarction Injury in Patients with Chronic Lung Disease Entering Pulmonary Rehabilitation: Frequency and Association with Heart Rate Parameters

PM&R ◽

10.1016/j.pmrj.2018.03.005 ◽

2018 ◽

Vol 10 (9) ◽

pp. 917-925

Author(s):

Carmen A. Sima ◽

Benny C. Lau ◽

Carolyn M. Taylor ◽

Stephan F. van Eeden ◽

W. Darlene Reid ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Rate ◽

Lung Disease ◽

Chronic Lung Disease ◽

Pulmonary Rehabilitation

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Response to Pulmonary Rehabilitation in Older People with Physical Frailty, Sarcopenia and Chronic Lung Disease

Geriatrics ◽

10.3390/geriatrics2010009 ◽

2017 ◽

Vol 2 (1) ◽

pp. 9 ◽

Cited By ~ 4

Author(s):

Luke Attwell ◽

Michael Vassallo

Keyword(s):

Older People ◽

Lung Disease ◽

Chronic Lung Disease ◽

Pulmonary Rehabilitation ◽

Physical Frailty

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Minimal versus specialist equipment in the delivery of pulmonary rehabilitation: protocol for a non-inferiority randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-047524 ◽

2021 ◽

Vol 11 (10) ◽

pp. e047524

Author(s):

Claire M Nolan ◽

Jessica A Walsh ◽

Suhani Patel ◽

Ruth E Barker ◽

Oliver Polgar ◽

...

Keyword(s):

Quality Of Life ◽

Lung Disease ◽

Exercise Capacity ◽

Chronic Lung Disease ◽

Pulmonary Rehabilitation ◽

Randomised Trial ◽

Global Rating ◽

Process Data ◽

Exercise Equipment

IntroductionPulmonary rehabilitation (PR), an exercise and education programme for people with chronic lung disease, aims to improve exercise capacity, breathlessness and quality of life. Most evidence to support PR is from trials that use specialist exercise equipment, for example, treadmills (PR-gym). However, a significant proportion of programmes do not have access to specialist equipment with training completed with minimal exercise equipment (PR-min). There is a paucity of robust literature examining the efficacy of supervised, centre-based PR-min. We aim to determine whether an 8-week supervised, centre-based PR-min programme is non-inferior to a standard 8-week supervised, centre-based PR-gym programme in terms of exercise capacity and health outcomes for patients with chronic lung disease.Methods and analysisParallel, two-group, assessor-blinded and statistician-blinded, non-inferiority randomised trial. 436 participants will be randomised using minimisation at the individual level with a 1:1 allocation to PR-min (intervention) or PR-gym (control). Assessment will take place pre-PR (visit 1), post-PR (visit 2) and 12 months following visit 1 (visit 3). Exercise capacity (incremental shuttle walk test), dyspnoea (Chronic Respiratory Questionnaire (CRQ)-Dyspnoea), health-related quality of life (CRQ), frailty (Short Physical Performance Battery), muscle strength (isometric quadriceps maximum voluntary contraction), patient satisfaction (Global Rating of Change Questionnaire), health economic as well as safety and trial process data will be measured. The primary outcome is change in exercise capacity between visit 1 and visit 2. Two sample t-tests on an intention to treat basis will be used to estimate the difference in mean primary and secondary outcomes between patients randomised to PR-gym and PR-min.Ethics and disseminationLondon-Camden and Kings Cross Research Ethics Committee and Health Research Authority have approved the study (18/LO/0315). Results will be submitted for publication in peer-reviewed journals, presented at international conferences, disseminated through social media, patient and public routes and directly shared with stakeholders.Trial registration numberISRCTN16196765.

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