Goal 3: Advance Translational Research

The impact of a COPD patient education program

What is the impact of an organized, comprehensive, COPD patient education program, on medication delivery effectiveness, care plan adherence, appropriate use of LTOT and Pulmonary Rehabilitation? Metrics could include incidence and severity of exacerbations, and health care resource consumption.

Submitted by (@dprieto)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Voting

11 net votes
15 up votes
4 down votes
Active

Goal 3: Advance Translational Research

Definitive Evidence of the Effectiveness of Pulmonary Rehabilitation

What is the clinical effectiveness of pulmonary rehabilitation in reducing hospital admissions and readmissions, improving health outcomes such as exercise tolerance and dyspnea, and positively impacting patient centered outcomes. Does this effectiveness vary based on the types of settings rehab is conducted in, urban vs rural environments, the components to the program, the timing of the program and the overall support ...more »

Submitted by (@gacdk0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Pulmonary rehabilitation is a critical component in the treatment of COPD patients but several barriers persist that have resulted in very limited access to rehab, low referral rates for eligible patients and limited standardization of best practices within the rehab facilities that do exist. Large, definitive studies accounting for patient subgroups, site characteristics and program components can generate the level of evidence needed to expand access, educate providers and improve referral systems and create quality programs. This level of evidence is necessary to change policy to properly value the role of pulmonary rehabilitation and to convince integrated health systems in a value based market that pulmonary rehabilitation is beyond a doubt, a requirement of providing quality COPD care.

Name of idea submitter and other team members who worked on this idea : Grace Anne Dorney Koppel, COPD Foundation Board of Directors, COPD Patient Advocate

Voting

9 net votes
12 up votes
3 down votes
Active

Goal 2: Reduce Human Disease

Pulmonary rehabilitation

Can pulmonary rehabilitation change the course of COPD? Is pulmonary rehabilitation a disease-modifying therapy? Does pulmonary rehabilitation improve survival? Does pulmonary rehabilitation reduce readmissions?

Submitted by (@makeb0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Pulmonary rehabilitation is the most effective therapy for COPD, leading to reduced shortness of breath and improved exercise capacity. It is under-utilized because of the relative paucity of studies evaluating its efficacy on mortality, hospitalization and hospital readmission.

Feasibility and challenges of addressing this CQ or CC :

Feasibility is very high. In the NIH National Emphysema Treatment Trial, a standardized pulmonary rehabilitation program was developed and implemented at multiple sites, many of which did not have existing pulmonary rehabilitation programs. The effective of this pulmonary rehabilitation program was documented (Chest 2005; 128:3799). Challenges include maintenance of the benefits of pulmonary rehabilitation using modern approaches to increase adherence.

Name of idea submitter and other team members who worked on this idea : Barry Make

Voting

20 net votes
26 up votes
6 down votes
Active

Goal 3: Advance Translational Research

A comparison of community- and hospital-based pulmonary rehabilitation programs

Compelling Question Text:

 

What is the comparative effectiveness and cost-effectiveness of community-based vs. hospital-based pulmonary rehabilitation programs?

Submitted by (@dmcgowan)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

The ability to reach more patients in need of recommended treatment for the COPD patient.

The availability is not always easy with transportation, cost, and coverage issues being the importatnt factors.

Feasibility and challenges of addressing this CQ or CC :

Easily feasible to address for home or community availability, like YMCAs, Senior Centers.

Voting

10 net votes
11 up votes
1 down votes
Active

Goal 3: Advance Translational Research

What is the comparative effectiveness of short-term vs. chronic (e.g., 12 mo) pulmonary rehabilitation?

What is the comparative effectiveness of short-term vs. chronic (e.g. 12 mos) pulmonary rehabilitation on survival, patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations), healthcare utilization, and costs from a societal and healthcare system perspective?

Submitted by (@jakris)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Modest sized efficacy trials demonstrate substantial health benefits, that wane as Pulmonary rehabilitation is discontinued. We need to test the health and resource implications of "chronic" (e.g., 12 or 24 mos) pulmonary rehabilitation. Such information will benefit health systems seeking to implement care models for high-risk, costly, patients - patients with COPD are of increasing interest to health systems. Such a comparative effectiveness trial should also involve behavioral interventions to promote self-management and involve caregivers.

Name of idea submitter and other team members who worked on this idea : Jerry Krishnan

Voting

26 net votes
32 up votes
6 down votes
Active

Goal 3: Advance Translational Research

Pulmonary Rehabilitation

What is the comparative effectiveness of short-term vs. chronic (indefinite) pulmonary rehabilitation on patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations)?

Submitted by (@fzaidi1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Farhan Zaidi, Jerry Krishnan

Voting

5 net votes
6 up votes
1 down votes
Active

Goal 2: Reduce Human Disease

Cardiac rehabilitation in congenital heart disease

Does cardiac rehabilitation in children with Fontan physiology increase exercise capacity over the long term?

What are the benefits? What is the appropriate dose? What other CHD populations may benefit from cardiac rehabilitation?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Improve functional capacity and quality of life of patients with congenital heart disease.

Feasibility and challenges of addressing this CQ or CC :

Preliminary data has been promising but larger clinical trials are needed.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-3 net votes
10 up votes
13 down votes
Active

Goal 3: Advance Translational Research

Effect of short-term vs. chronic pulmonary rehabilitation on patient-reported outcomes

What is the comparative effectiveness of short-term vs. chronic (indefinite) pulmonary rehabilitation on patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations)?

Submitted by (@scerreta)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Voting

14 net votes
19 up votes
5 down votes
Active