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

Area of Science:

• Pulmonary Medicine
• Health Services Research

Background:

• Pulmonary rehabilitation (PR) offers significant benefits for patients with chronic obstructive pulmonary disease (COPD).
• An enhanced PR program incorporating self-management education was developed to improve patient outcomes.
• This study aimed to assess the implementation of this enhanced PR program within a single clinical center.

Purpose of the Study:

• To evaluate the implementation of an enhanced pulmonary rehabilitation program for COPD patients.
• To assess the program's reach, effectiveness, adoption, implementation fidelity, and maintenance over 18 months.
• To determine patient and healthcare professional satisfaction with the enhanced PR program.

Main Methods:

• A pre-post implementation study design was employed with two evaluation periods.
• The RE-AIM framework guided the assessment of Reach, Effectiveness, Adoption, Implementation, and Maintenance.
• Data collection included patient enrollment rates, functional exercise capacity, knowledge, self-efficacy, healthcare professional participation, and fidelity metrics.

Main Results:

• The enhanced PR program achieved good reach (70-75% patient agreement) and adoption by all involved healthcare professionals.
• Clinically important improvements were observed in functional exercise capacity, knowledge, functional status, and self-efficacy.
• High implementation fidelity (76-95%) was maintained, and the program proved sustainable over 18 months with minor modifications.

Conclusions:

• The enhanced PR program was well-accepted by both patients and healthcare professionals.
• Successful implementation and maintenance of the enhanced PR program were demonstrated at a single expert center.
• The program exhibited good implementation fidelity and high satisfaction levels, indicating its viability and effectiveness.