Sridhar 2008.
| Study characteristics | ||
| Methods | RCT; 104 weeks; control group: usual care | |
| Participants | Eligible: 297 Randomised: 122, I: 61, C: 61 Completed: 104, I: 55, C: 49 Mean age both groups: 70 years Sex (% male): both groups: 49 Inclusion criteria: diagnosis of COPD and admitted between 2000 and 2004 with acute exacerbation of COPD Exclusion criteria: significant comorbidity (severe heart disease or cancer, or any condition that would preclude participation in physical therapy component of PR programme) |
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| Interventions | Nurse‐led intermediate care package ‐ Patients started with PR programme for 4 weeks, including general education about disease and treatment, and physical training programme ‐ After 4 weeks, patients received a home visit, including a written COPD action plan for exacerbations. GPs provided medication ‐ Patients received monthly telephone calls and a home visit every 3 months until 24 months' follow‐up. Calls reinforced advice regarding treatments, smoking cessation, need to continue exercise therapy; reinforced self‐management education Intervention duration: 24 months Disciplines involved: GP, nurse, physiotherapist |
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| Outcomes | CRQ, mortality, exacerbations, hospital admissions, lung function | |
| Notes | Dominant component: exercise and action plan | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "122 patients were suitable and were recruited and randomised by the use of random numbers to the intervention and control group" |
| Allocation concealment (selection bias) | Unclear risk | Comment: n o information provided |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Comment: p articipants and treating therapists not likely to have been blinded to group allocation |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Comment: n o information provided |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Comment: d ropout rates comparable between groups |
| Selective reporting (reporting bias) | Low risk | Comment: study protocol is not available, but it is clear that published reports include all expected outcomes, including those that were pre‐specified |