Implementation and maintenance of an enhanced pulmonary rehabilitation program in a single centre: An implementation study

Kim van der Braak, Joshua Wald, Catherine M Tansey, Thais Paes, Maria Sedeno, Anne-Marie Selzler, Michael K Stickland, Jean Bourbeau, Tania Janaudis-Ferreira*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Pulmonary rehabilitation (PR) has major benefits for patients with chronic obstructive pulmonary disease (COPD). An enhanced PR program was developed with a self-management education intervention. The objective of our study was to evaluate the implementation of the enhanced PR program into a single centre.

METHODS: Pre-post implementation study consisted of two evaluation periods: immediately after implementation and 18 months later. Guided by the RE-AIM framework, outcomes included: Reach, Effectiveness, Adoption, Implementation and Maintenance.

RESULTS: Reach: 70-75% of referred patients agreed to a PR program (n = 26). Effectiveness: Clinically important improvements occurred in some patients in functional exercise capacity (64% of the patients achieved clinical important difference in 6-min walk test in the first evaluation period and 44% in the second evaluation period), knowledge, functional status, and self-efficacy in both evaluation periods. Adoption: All healthcare professionals (HCPs) involved in PR (n = 8) participated. Implementation: Fidelity for the group education sessions ranged from 76 to 95% (first evaluation) and from 82 to 88% (second evaluation). Maintenance: The program was sustained over 18 months with minor changes. Patients and HCPs were highly satisfied with the program.

CONCLUSIONS: The enhanced PR program was accepted by patients and HCPs and was implemented and maintained at a single expert center with good implementation fidelity.

Original languageEnglish
Article number14799731231179105
JournalChronic Respiratory Disease
Volume20
DOIs
Publication statusPublished - 1 Jan 2023

Keywords

  • Chronic obstructive pulmonary disease
  • RE-AIM framework
  • implementation
  • maintenance
  • pulmonary rehabilitation

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