Developing an intervention to increase REferral and uptake to pulmonary REhabilitation in primary care in patients with chronic obstructive pulmonary disease (the REsTORE study) : Mixed methods study protocol

Journal article


Early, Frances, Wilson, Patricia, Deaton, Christi, Wellwood, Ian, Dickerson, Terry, Ward, James, Jongepier, Lianne, Barlow, Ruth, Singh, Sally J., Benson, John, Brimicombe, James, Kim, Lois, Haque, Hena and Fuld, Jonathan. (2019). Developing an intervention to increase REferral and uptake to pulmonary REhabilitation in primary care in patients with chronic obstructive pulmonary disease (the REsTORE study) : Mixed methods study protocol. BMJ Open. 9(1), p. Article e024806. https://doi.org/10.1136/bmjopen-2018-024806
AuthorsEarly, Frances, Wilson, Patricia, Deaton, Christi, Wellwood, Ian, Dickerson, Terry, Ward, James, Jongepier, Lianne, Barlow, Ruth, Singh, Sally J., Benson, John, Brimicombe, James, Kim, Lois, Haque, Hena and Fuld, Jonathan
Abstract

Introduction Chronic obstructive pulmonary disease (COPD) is a progressive lung disease associated with breathlessness, inability to exercise, frequent infections, hospitalisation and reduced quality of life. Pulmonary rehabilitation (PR), providing supervised exercise and education, is an effective and cost-effective treatment for COPD but is significantly underused. Interventions to improve referral and uptake have been tested and some positive results reported. However, interventions are diverse and no clear recommendations for practice can be made. This study aims to understand the challenges to referral and uptake in primary care, where most referrals originate, and to develop a flexible toolkit of resources to support referral and uptake to PR in primary care in the UK.

Methods and analysis This is a mixed methods study informed by normalisation process theory and burden of treatment theory. In the first phase, general practitioners, practice nurses and PR providers will be invited to complete an online survey to inform a broad exploration of the topic areas. In phase 2 interviews and focus groups will be conducted with patients, healthcare professionals (HCP) in primary care, PR providers and commissioners to gain an in-depth understanding of the issues and needs. Toolkit development in phase 3 will draw together the learning from phases 1 and 2 and employ an iterative development process to build the toolkit jointly with patients and HCPs. It will be tested in primary care for usability and acceptability.

Ethics and dissemination The study has ethical and Health Research Authority approval (Research Ethics Committee reference number 17/EE/0136). It is registered with the International Standard Registered Clinical/Social Study Number (ISRCTN) registry (trial ID: ISRCTN20669629, assignment date 20 March 2018, trial start date 1 April 2016). Dissemination will be aimed at patients, carers/families, service providers, commissioners and national interest groups. Methods will include conferences, presentations, academic publications and plain English reports and will be supported by the British Lung Foundation.

Trial registration number ISRCTN20669629 ; Pre-results.

Year2019
JournalBMJ Open
Journal citation9 (1), p. Article e024806
PublisherBMJ Publishing Group
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2018-024806
PubMed ID30670521
Scopus EID2-s2.0-85060374916
PubMed Central IDPMC6347857
Open accessPublished as ‘gold’ (paid) open access
Page range1-9
FunderNational Institute for Health Research (NIHR)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online21 Jan 2019
Publication process dates
Accepted31 Oct 2018
Deposited29 Sep 2023
Grant IDPB-PG-1215-20034
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