Chronic Obstructive Pulmonary Disease Access and Adherence to Pulmonary Rehabilitation Intervention (CAPRI): Protocol for a randomized controlled trial and adaptations during the COVID-19 pandemic.

Chronic obstructive pulmonary disease Daily step count Pedometer Physical activity Protocol Pulmonary rehabilitation Web-based

Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
06 2023
Historique:
received: 08 02 2023
accepted: 17 04 2023
medline: 29 5 2023
pubmed: 22 4 2023
entrez: 21 04 2023
Statut: ppublish

Résumé

Pulmonary rehabilitation (PR) is the standard of care for chronic obstructive pulmonary disease (COPD) management. However, significant barriers limit access and adherence to PR and alternatives are needed. The purpose of this randomized controlled trial is to test the efficacy of a web-based, pedometer-mediated intervention to increase physical activity (PA) for persons with COPD who decline PR or meet U.S. guidelines for referral to PR but have not participated (CAPRI-1). In addition, we will test whether the intervention maintains PA following PR in an exploratory aim (CAPRI-2). Participants with COPD (N = 120) will be recruited and randomized 1:1 to a 12-week web-based, pedometer-mediated intervention or usual care (UC) (CAPRI-1). The intervention provides: 1) objective monitoring of walking and iterative feedback, 2) individualized step-count goals, 3) motivational messages and educational content, and 4) an online community. The primary outcome is change in daily step count from baseline to 12 weeks. Secondary outcomes include: (a) exercise capacity; (b) self-reported PA; (c) PA intensity; (d) exercise self-regulatory efficacy, (e) health-related quality of life, (f) dyspnea, (g) depression symptoms, and (h) healthcare utilization. CAPRI-2 will test whether participants (N = 96) assigned to the intervention following PR completion show greater maintenance of daily step count compared to UC at 3, 6, 9, and 12 months. If the intervention is efficacious, it may be an alternative for those who cannot attend PR or a maintenance program following completion of conventional PR. We also present adaptations made to the protocol in response to the COVID-19 pandemic.

Sections du résumé

BACKGROUND
Pulmonary rehabilitation (PR) is the standard of care for chronic obstructive pulmonary disease (COPD) management. However, significant barriers limit access and adherence to PR and alternatives are needed. The purpose of this randomized controlled trial is to test the efficacy of a web-based, pedometer-mediated intervention to increase physical activity (PA) for persons with COPD who decline PR or meet U.S. guidelines for referral to PR but have not participated (CAPRI-1). In addition, we will test whether the intervention maintains PA following PR in an exploratory aim (CAPRI-2).
METHODS
Participants with COPD (N = 120) will be recruited and randomized 1:1 to a 12-week web-based, pedometer-mediated intervention or usual care (UC) (CAPRI-1). The intervention provides: 1) objective monitoring of walking and iterative feedback, 2) individualized step-count goals, 3) motivational messages and educational content, and 4) an online community. The primary outcome is change in daily step count from baseline to 12 weeks. Secondary outcomes include: (a) exercise capacity; (b) self-reported PA; (c) PA intensity; (d) exercise self-regulatory efficacy, (e) health-related quality of life, (f) dyspnea, (g) depression symptoms, and (h) healthcare utilization. CAPRI-2 will test whether participants (N = 96) assigned to the intervention following PR completion show greater maintenance of daily step count compared to UC at 3, 6, 9, and 12 months.
DISCUSSION
If the intervention is efficacious, it may be an alternative for those who cannot attend PR or a maintenance program following completion of conventional PR. We also present adaptations made to the protocol in response to the COVID-19 pandemic.

Identifiants

pubmed: 37084881
pii: S1551-7144(23)00126-X
doi: 10.1016/j.cct.2023.107203
pmc: PMC10113592
pii:
doi:

Types de publication

Clinical Trial Protocol Journal Article Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

107203

Subventions

Organisme : RRD VA
ID : IK2 RX003527
Pays : United States
Organisme : RRD VA
ID : I01 RX002855
Pays : United States

Informations de copyright

Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Patricia M Bamonti (PM)

Research & Development, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

Stephanie A Robinson (SA)

Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA; The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.

Elizabeth Finer (E)

Research & Development, VA Boston Healthcare System, Boston, MA, USA.

Reema Kadri (R)

Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

David Gagnon (D)

Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Public Health, Boston, MA, USA.

Caroline R Richardson (CR)

Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

Marilyn L Moy (ML)

Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: marilyn.moy@va.gov.

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Classifications MeSH