An observational cohort study of exercise and education for people with chronic obstructive pulmonary disease not meeting criteria for formal pulmonary rehabilitation programmes

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality. Pulmonary Rehabilitation (PR) is offered to patients with functional breathlessness. However, access to PR is limited. The objective of this study was to evaluate whether a four week education and exercise programme offered to COPD patients with Medical Research Council (MRC) dyspnoea 1-2 improves disease self-management. Methods: Patients were recruited by their GP to attend four weekly, two- hour sessions provided by a multidisciplinary team. Patients completed outcome measures before and after the programme. Results: Forty two patients entered The programme and 26 out of 42 (61.9%) completed all sessions. The Bristol COPD Knowledge Questionnaire and Patient Activation Measure improved (both p≤0.001). Disease burden was not reduced according to the COPD Assessment Test. All patients accepted a referral for ongoing exercise. Fourteen current smokers (81.3%) accepted a referral for smoking cessation, 3 patients with anxiety or depression (37.5%) accepted a psychological therapies referral. Discussion: The programme improved COPD disease knowledge, patient activation and stimulated referrals to further services supporting disease management. Randomised controlled trials are warranted for similar interventions for COPD patients with early stage disease