1. 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
- Author
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Sally J Singh, Ruth Barlow, Christi Deaton, James Ward, Hena Wali Haque, Frances Early, T. Dickerson, John M. Benson, Patricia M. Wilson, James Brimicombe, Lianne Jongepier, Lois G. Kim, Ian Wellwood, Jonathan Fuld, Deaton, Christi [0000-0003-3209-0752], Wellwood, Ian [0000-0002-6059-9209], Dickerson, Terry [0000-0001-6902-9504], Ward, James [0000-0002-0362-4711], Brimicombe, James [0000-0002-3443-3256], Kim, Lois [0000-0002-4552-3820], Fuld, Jonathan [0000-0003-1847-184X], and Apollo - University of Cambridge Repository
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Research design ,medicine.medical_specialty ,Referral ,quality in healthcare ,medicine.medical_treatment ,Cost-Benefit Analysis ,Psychological intervention ,03 medical and health sciences ,primary care ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Quality of life (healthcare) ,Patient Education as Topic ,Surveys and Questionnaires ,Protocol ,Medicine ,respiratory medicine (see thoracic medicine) ,Humans ,Pulmonary rehabilitation ,030212 general & internal medicine ,Respiratory Medicine ,Exercise ,Referral and Consultation ,Qualitative Research ,Research ethics ,Primary Health Care ,business.industry ,rehabilitation medicine ,General Medicine ,Focus Groups ,Focus group ,030228 respiratory system ,Research Design ,Family medicine ,chronic airways disease ,Quality of Life ,business ,Qualitative research - Abstract
IntroductionChronic 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 analysisThis 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 disseminationThe 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 numberISRCTN20669629; Pre-results.
- Published
- 2019