A Feasibility Study of a Randomized Controlled Trial of Asthma-Tailored Pulmonary Rehabilitation Compared with Usual Care in Adults with Severe Asthma.

Airway inflammation Exercise Exercise training Feasibility study Pulmonary rehabilitation Quality of life Severe asthma

Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
Historique:
received: 05 02 2020
revised: 23 05 2020
accepted: 26 05 2020
pubmed: 13 6 2020
medline: 15 5 2021
entrez: 13 6 2020
Statut: ppublish

Résumé

Currently, the acceptability and efficacy of pulmonary rehabilitation for adults with severe asthma is unknown. To investigate the feasibility of performing a randomized controlled trial of asthma-tailored pulmonary rehabilitation (AT-PR) versus usual care (UC). Adults with severe asthma were recruited and randomized 2:1 to AT-PR and UC. The primary outcomes were recruitment, retention, and serious adverse event rates. Secondary outcome measures included those for a future trial assessing the feasibility of collecting data. Assessments were performed at baseline, 12 weeks, and 9 months including measures of physical performance, health-related quality of life, and asthma control. A recruitment rate of 30% was estimated with 95% CI of ±7%, a retention rate of 75% ± 14% if we recruited 40 patients to AT-PR, and a serious adverse event rate of 2.5%. Sixty-one (26%) of 238 eligible patients were recruited (38 women; mean age, 54 ± 13 years; body mass index, 32 ± 7 kg/m Both recruitment and retention rates were within the a priori estimated 95% CI. Our results indicate that AT-PR may be efficacious for adults with severe asthma but any future intervention and trial design would need further modifications to improve acceptability and retention rate.

Sections du résumé

BACKGROUND
Currently, the acceptability and efficacy of pulmonary rehabilitation for adults with severe asthma is unknown.
OBJECTIVE
To investigate the feasibility of performing a randomized controlled trial of asthma-tailored pulmonary rehabilitation (AT-PR) versus usual care (UC).
METHODS
Adults with severe asthma were recruited and randomized 2:1 to AT-PR and UC. The primary outcomes were recruitment, retention, and serious adverse event rates. Secondary outcome measures included those for a future trial assessing the feasibility of collecting data. Assessments were performed at baseline, 12 weeks, and 9 months including measures of physical performance, health-related quality of life, and asthma control. A recruitment rate of 30% was estimated with 95% CI of ±7%, a retention rate of 75% ± 14% if we recruited 40 patients to AT-PR, and a serious adverse event rate of 2.5%.
RESULTS
Sixty-one (26%) of 238 eligible patients were recruited (38 women; mean age, 54 ± 13 years; body mass index, 32 ± 7 kg/m
CONCLUSIONS
Both recruitment and retention rates were within the a priori estimated 95% CI. Our results indicate that AT-PR may be efficacious for adults with severe asthma but any future intervention and trial design would need further modifications to improve acceptability and retention rate.

Identifiants

pubmed: 32531482
pii: S2213-2198(20)30593-6
doi: 10.1016/j.jaip.2020.05.052
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3418-3427

Subventions

Organisme : Department of Health
ID : PB-PG-0712-28063
Pays : United Kingdom
Organisme : Department of Health
ID : CS-2016-16-020
Pays : United Kingdom

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

Sally Majd (S)

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom.

Lindsay Apps (L)

Faculty of Health & Life Sciences, Institute for Psychological Sciences, DeMontfort University, Leicester, United Kingdom.

Stacey Chantrell (S)

Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom.

Nicky Hudson (N)

Centre for Reproduction Research, Applied Social Science, DeMontfort University, Leicester, United Kingdom.

Elizabeth Eglington (E)

Glenfield Hospital, Leicester, United Kingdom.

Beverley Hargadon (B)

Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom.

Anna Murphy (A)

Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom.

Sally J Singh (SJ)

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom.

Peter Bradding (P)

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom.

Ruth H Green (RH)

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom.

Rachael A Evans (RA)

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR, Biomedical Research Centre-Respiratory Theme, Glenfield Hospital, Leicester, United Kingdom; Department of Respiratory Medicine, Thoracic Surgery and Allergy, Glenfield Hospital, Leicester, United Kingdom. Electronic address: re66@leicester.ac.uk.

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