Outcome measures in a combined exercise rehabilitation programme for adults with COPD and chronic heart failure: A preliminary stakeholder consensus event

Combined exercise rehabilitation for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) is potentially attractive. Uncertainty remains as to the baseline profiling assessments and outcome measures that should be collected within a programme. Current evidence surrounding outcome measures in cardiac and pulmonary rehabilitation were presented by experts at a stakeholder consensus event and all stakeholders (n = 18) were asked to (1) rank in order of importance a list of categories, (2) prioritise outcome measures and (3) prioritise baseline patient evaluation measures that should be assessed in a combined COPD and CHF rehabilitation programme. The tasks were completed anonymously and related to clinical rehabilitation programmes and associated research. Health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes (median rank: 1, 2 and 3 accordingly) and research purposes (median rank; 1, 3 and 4.5 accordingly) within combined exercise rehabilitation. All stakeholders agreed that profiling symptoms at baseline were ‘moderately’, ‘very’ or ‘extremely’ important to assess for clinical and research purposes in combined rehabilitation. Profiling of frailty was ranked of the same importance for clinical purposes in combined rehabilitation. Stakeholders identified a suite of multidisciplinary measures that may be important to assess in a combined COPD and CHF exercise rehabilitation programme.

Contributors

Jones AV1,2, Evans RA3, Man WD4, Bolton CE5, Breen S6, Doherty PJ7, Gardiner N8, Houchen-Wolloff L2, Hurst JR9, Jolly K10, Maddocks M11, Quint JK12, Revitt O8, Sherar LB1, Taylor RS13, Watt A8, Wingham J13, Yorke J14, Singh SJ2.

Author information

1
National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
2
Centre for Exercise and Rehabilitation Science, NIHR Leicester Respiratory Biomedical Research Unit Centre, Glenfield Hospital, Leicester, UK.
3
Department of IIIs and Health Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester, UK.
4
Royal Brompton & Harefield NHS Foundation Trust, National Heart and Lung Institute, Imperial College, Harefield Pulmonary Rehabilitation and Muscle Research Laboratory, Harefield Hospital, UK.
5
Division of Respiratory Medicine and NIHR Nottingham BRC Respiratory Theme, School of Medicine, University of Nottingham, Nottingham City Hospital Campus, Nottingham, UK.
6
Manchester Royal Infirmary, Manchester, UK.
7
Department of Health Sciences, University of York, York, UK.
8
University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
9
University College London Respiratory, London, UK.
10
Institute of Applied Health Research, Murray Learning Centre, University of Birmingham Edgbaston, Birmingham, UK.
11
King's College London, Cicely Saunders Institute, London, UK.
12
NHLI, Imperial College London, London, UK.
13
University of Exeter Medical School, South Cloisters, St Lukes Campus, Exeter, UK.
14
School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.

Publication

Journal: Chronic Respiratory Disease
Volume: 16
Issue:
Pages: -
Year:
DOI: 10.1177/1479973119867952

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: RAE is an NIHR fellow.MMis supported by an NIHR Career Development Fellowship (CDF-2017-009) and by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London. CEB is supported by the NIHR Nottingham BRC, Respiratory Theme. WDCM was partly supported by CLAHRC Northwest London at the time of the consensus meeting. SJS is supported by CLAHRC East Midlands.


Health Area

Disease Category: Heart & circulation, Lungs & airways

Disease Name: Chronic heart failure , Chronic obstructive pulmonary disease (COPD)

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Exercise, Rehabilitation

Stakeholders Involved

- Clinical experts
- Researchers

Study Type

- Prioritising

Method(s)

- Consensus meeting
- Literature review

Current evidence surrounding outcome measures in cardiac and pulmonary rehabilitation were presented by experts at a stakeholder consensus event and all stakeholders (n = 18) were asked to (1) rank in order of importance a list of categories, (2) prioritise outcome measures and (3) prioritise baseline patient evaluation measures that should be assessed in a combined COPD and CHF rehabilitation programme. The tasks were completed anonymously and related to clinical rehabilitation programmes and associated research. Health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes (median rank: 1, 2 and 3 accordingly) and research purposes (median rank; 1, 3 and 4.5 accordingly) within combined exercise rehabilitation.

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