Chronic obstructive pulmonary disease self-management activation research trial (COPD-SMART): design and methods

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Behavioral Science

Background:

• Chronic Obstructive Pulmonary Disease (COPD) management necessitates multifaceted interventions.
• Physical inactivity exacerbates COPD-related disability and negatively impacts physical and mental health.
• Limited access to pulmonary rehabilitation affects a vast majority of eligible COPD patients.

Purpose of the Study:

• To evaluate a self-management lifestyle physical activity intervention for COPD patients.
• To determine the intervention's efficacy in improving physical functioning and reducing dyspnea.
• To provide an accessible alternative for patients unable to attend center-based pulmonary rehabilitation.

Main Methods:

• A single-site, parallel-group randomized trial was conducted.
• Participants received COPD self-management education followed by randomization to usual care or the physical activity intervention.
• The intervention involved a 20-week program with workbooks, telephone counseling, and computer-assisted calls, guided by social cognitive theory and the transtheoretical model.

Main Results:

• Primary outcomes include changes in Chronic Respiratory Questionnaire (CRQ) dyspnea scores and 6-minute walk distance at 6, 12, and 18 months post-randomization.
• Secondary outcomes encompass other CRQ domains (fatigue, emotion, mastery), SF-12 scores, and healthcare utilization.
• Process outcomes and clinical characteristics were also measured.

Conclusions:

• The theory-driven, self-management lifestyle physical activity intervention is designed for COPD patients facing barriers to center-based pulmonary rehabilitation.
• Study findings are expected to enhance knowledge and dissemination strategies for a potentially cost-effective COPD management program.