SPACE FOR COPD maintenance
Research type
Research Study
Full title
SPACE FOR COPD© delivered as a maintenance programme on Pulmonary Rehabilitation discharge: a randomised controlled trial evaluating the long-term effects on exercise tolerance and mental wellbeing
IRAS ID
262581
Contact name
Linzy Houchen-Wolloff
Contact email
Sponsor organisation
University Hospitals of Leicester NHS Trust
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Chronic obstructive pulmonary disease describes a group of lung conditions that make it difficult to empty air out of the lungs because the airways are narrowed. Patients suffer from shortness of breath and tend to avoid activities which make them breathless, causing muscles to waste and weaken. An added problem is that patients often have repeated chest infections, some requiring hospital admission. This is detrimental for the patient and costly for the health service. Pulmonary Rehabilitation is a package of supervised exercise and education which is known to improve physical and mental well-being, as well as preventing hospital admissions in patients with COPD. However the benefits of rehabilitation do not last and patients talk about a feeling of ‘abandonment’ at the end of the programme. The aim of this research is to test a new maintenance (on-going support) programme for patients with COPD. In this study, we will divide people into two groups at the end of rehabilitation. One group will receive best usual care including referral to a community exercise programme if wanted. The second group will receive best usual care plus the new maintenance programme. In this programme, patients will work through a booklet and attend group sessions for 12-months to gain support from patients and staff. All patients will do several tests over 12-months to measure physical and mental well-being. We will also interview patients and staff about their experiences of the programme. If successful, the new maintenance programme has the potential to preserve and enhance the benefits of rehabilitation for the patient. This may reduce hospital admissions, saving the health service money. This study was developed in response to patient feedback and with the support of patient representatives. The findings of the study will be announced at conferences, in publications and at patient groups.
Lay summary of study results:
Aims/ objectives: To assess whether a self-management maintenance programme (SPACE FOR COPD), delivered after Pulmonary Rehabilitation (PR), preserves the gains made in exercise tolerance and mental well-being at 12months, compared with usual care alone, in patients with Chronic Obstructive Pulmonary Disease.
Background: The benefits achieved during pulmonary rehabilitation (PR) are known to decline 6–12 months after the initial programme. There is no consensus on the best maintenance strategy. SPACE FOR COPD (Self-management Programme of Activity, Coping and Education for COPD) is a home-based self management programme, which has been shown to be previously effective and was tested in this study as a maintenance programme.
Methods: 116 participants with COPD who had finished PR were allocated to either usual care or the SPACE maintenance programme. The SPACE group received a home-based manual and 4 group sessions for 12months. The main outcome of interest was walking time. Other outcomes included quality of life, mood, patient activation, physical activity and healthcare costs measured at the start of the research, at 6 and 12months. We conducted interviews with patients and staff to understand their experiences.
Key findings: There were no differences between groups for clinical outcomes however the SPACE programme was cost saving for the NHS, due to reduced GP visits. Interviews revealed that participants’
valued healthcare professional support and the need to take a personalised approach when setting meaningful goals.
Dissemination, outputs, impact: Planned lay and scientific publications to follow, including a public results event.
Patient and public involvement: Patient representatives have been involved in all aspects of the study and continue to support publicising results.
Conclusions, future plans: Whilst there were no differences between groups for walking distance, our economic evaluation shows that investment in a maintenance programme following PR could save the NHS money. Patients valued ongoing healthcare professional support following PR.REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
19/EM/0267
Date of REC Opinion
3 Oct 2019
REC opinion
Further Information Favourable Opinion