PReSent

  • Research type

    Research Study

  • Full title

    The development and feasibility testing of a Pulmonary Rehabilitation Shared Decision Making intervention for patients with Chronic Obstructive Pulmonary Disease (PReSent)

  • IRAS ID

    288873

  • Contact name

    Amy Barradell

  • Contact email

    ab1081@le.ac.uk

  • Sponsor organisation

    University Hospitals of Leicester NHS Trust

  • Clinicaltrials.gov Identifier

    NCT04990180

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Summary of Research
    This protocol aims to clarify the need for a shared decision making (SDM) intervention to support patients with Chronic Obstructive Pulmonary Disease (COPD) access Pulmonary Rehabilitation (PR) and to test its feasibility.
    PR is an evidence-based intervention for patients with COPD however, referral suffers poor referral and uptake. One barriers to accessing PR at University Hospitals of Leicester (UHL) is healthcare professionals (HCPs) beliefs about patient motivation (e.g. believing patients to be unmotivated reduces their desire to offer them PR). This shows HCPs have conscious (explicit) bias but little is known about whether they also have unconscious (implicit) bias. It is important to measure this as it can also shape attitudes and therefore referral behaviour.
    The first objective is to measure HCPs implicit bias. UK HCPs who refer patients to PR will be invited to complete a one-off computerised Implicit Association Test (IAT), adapted to measure their bias towards the behaviours of patients living with COPD (i.e. smoking, exercising).
    The second objective is to test the feasibility and acceptability of a SDM intervention (a patient decision aid and decision coaching for PR specialists). Patients with COPD will receive the decision aid upon referral to PR. At their PR assessment they will engage in SDM with their trained PR specialist to decide on their preferred PR programme. Following completion/drop out from PR, patients and trained PR specialists will also be invited to take part in either a focus group (patients) or interview (PR specialist) to assess the acceptability of the intervention. Fidelity of the intervention will be measured by audio-recording and analysing the intervention sessions.
    The findings will contribute to the CI's PhD. This study is funded by the National Institute for Health Research Applied Research Collaboration (East Midlands) and the Centre for Exercise and Rehabilitation Science.

    Summary of Results
    The findings showed that the study processes and the intervention were feasible to deliver. Early data suggest the intervention may help to reduce individuals' decisional conflict. Individuals and healthcare professionals felt the intervention was acceptable and helped individuals to make good decisions about PR. There were some suggestions on how it could be improved before future testing. For example, simplifying and further personalising the patient decision aid and providing more scenarios for healthcare professionals to reflect on during the decision coaching training training.

    Next steps
    The next steps are to update the PR SDM intervention materials and then test its efficacy in a randomised controlled trial.

    Where can I find out more?
    The protocol for this research can be found at https://u2790089.ct.sendgrid.net/ls/click?upn=Xv3JSvJ-2B3M71ppf7N9agbeGbmQmMfeY6MTsuMZ7e1y4ebGYG5Uy9n-2FUEEJwx9KRrQkJse-2B26U51tSvQYJT4OBw-3D-3DW1iN_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YLsfrTlZwEk7r1y3pARAIqqmUSsaTAQ10lOdw0DnW-2FZI7ME3eS6BQgoI1yqZlsr4NAt4byXeo0z5wyEetO3yDf5vW7CeUU2eZcTni1lWqoqWkv2bHtv5p9OcTgocM9iC1-2B0-2Bigs-2BpzIliwQnx75d4sj3BrQrz-2FWqAChE19lP7l5eCc8J6IphxnpwnVBHbMmb10-3D or if you would like a paper copy you can contact Amy Barradell on Amy.Barradell@uhl-tr.nhs.uk

    The results of this research will be shared in scientific journals soon.

  • REC name

    East Midlands - Leicester South Research Ethics Committee

  • REC reference

    21/EM/0084

  • Date of REC Opinion

    14 May 2021

  • REC opinion

    Further Information Favourable Opinion