• Dympna Casey, Kathy Murphy, Declan Devane, Adeline Cooney, Bernard McCarthy, Lorraine Mee, John Newell, Eamon O'Shea, Carl Scarrott, Paddy Gillespie, Collette Kirwan, and Andrew W Murphy.
• School of Nursing and Midwifery, National University of Ireland, , Galway, Ireland.
• Thorax. 2013 Oct 1; 68 (10): 922-8.

ObjectiveTo evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).DesignTwo-arm, cluster randomised controlled trial.Setting32 general practices in the Republic of Ireland.Participants350 participants with a diagnosis of moderate or severe COPD.InterventionExperimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.Main Outcome MeasureHealth status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12-14 weeks postcompletion of the programme.ResultsParticipants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.ConclusionsA primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.Trial RegistrationISRCTN52403063.

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