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Community-based programme helps patients better manage lung disease

18 January 2012

A HRB-funded study carried out at NUI Galway has shown a significant improvement in managing breathing difficulties among people suffering from chronic obstructive pulmonary disease (COPD), using a community-based approach involving nurses, GP practices and physiotherapists.

According to Enda Connolly, Chief Executive at the Health Research Board,

'This is an important finding which when implemented will mean that patients can expect better treatment which over time holds significant potential to deliver better health outcomes for them.

It is an excellent example of how investments in health services research can pay dividends in terms of improving patient care and more effective delivery of health services. The HRB will continue to invest in practical, patient-oriented research that delivers better outcomes and improved efficiencies.'

The PRINCE (Pulmonary Rehabilitation in Nurse-led Community Environment) study was funded by the HRB, and consisted of a two-armed randomised cluster trial. In one arm (intervention group), persons with COPD received a structured education pulmonary rehabilitation programme, while the other arm (control group) received usual care.

COPD is a progressive disease that makes it hard to breathe. The disease can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. While cigarette smoking is the leading cause of COPD, long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.

The study is one of the largest pulmonary rehabilitation trials conducted in primary care.

The pulmonary rehabilitation programme was specifically designed by the study team for clients living in the community with COPD. The programme was delivered in GP practices or venues close by and facilitated by practice nurses and physiotherapists who were trained by the PRINCE study team to facilitate the programme. The content of the programme included medication management, breathing techniques and exercise training. It was delivered two hours per week over eight weeks.

The study found that people who attended the programme were significantly better able to manage their breathing difficulties than those who did not attend.

Principal study investigators Professor Kathy Murphy and Dr Dympna Casey, from the School of Nursing at NUI Galway, are excited by the study findings. Professor Murphy commented,

'We both feel strongly that health care research must make a real difference to patients' lives and we are delighted that the findings of our large trial does just that. Our study found that a community based pulmonary rehabilitation programme facilitated by trained physiotherapists and practice nurses who had no prior COPD expertise, is feasible, safe, and effective. Not only that, but it makes a real difference to patients with moderate to severe COPD by improving their shortness of breath and physical functioning.'

More details are available from the press release on the NUI Galway website.

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