Community-based COPD project made a 'difference'

A COMMUNITY-BASED approach to assisting people with severe breathing difficulties has shown a “significant improvement” in management of the condition, according to a NUI Galway (NUIG) study.

People with chronic obstructive pulmonary disease (COPD) who attended an eight-week programme delivered by practice nurses and physiotherapists were far better able to manage than those who did not attend, the study revealed.

The project, which was funded by the Health Research Board (HRB), is said to be one of the largest such trials for pulmonary rehabilitation in primary care.

COPD is a progressive disease which makes it harder to breathe, and those diagnosed tend to have symptoms including coughing, wheezing, shortness of breath, chest tightness and production of large amounts of mucus.

Cigarette smoking is said to be the leading cause, but long-term exposure to air pollution, chemical fumes, dust and other lung irritants can also lead to the condition, according to the NUIG study team.

The team involved in the Pulmonary Rehabilitation in Nurse-led Community Environment (Prince) study worked with two groups – an intervention group, where volunteers were given a structured pulmonary rehabilitation education programme, and a control group which received the usual care.

The programme was delivered in GP practices or venues close to two hours a week over eight weeks by the nursing and physiotherapy staff trained by the Prince group. They focused on medication management, breathing techniques and exercise training.

Principal study investigators Prof Kathy Murphy and Dr Dympna Casey of NUIG’s school of nursing said they were delighted the trial findings made a “real difference to patients’ lives”.

The community-based programme was both “feasible, safe and effective”, they said, and also improved the physical functioning of those with moderate to severe COPD.

“By involving the practitioners who work within primary care . . we have helped to strengthen and build capacity,” Dr Casey said.

“Our work shows that it is possible to expand the scope of pulmonary rehabilitation practice in Ireland from hospital-based to community-based programmes,” she added.

The study findings were presented at a respiratory symposium held late last week in NUIG, chaired by Andrew Murphy, professor of general practice at the university.