A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial

BMJ Open. 2017 Jul 10;7(7):e014463. doi: 10.1136/bmjopen-2016-014463.

Abstract

Introduction: National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention.

Methods and analysis: A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically.

Ethics and dissemination: The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, via the Collaboration and Leadership in Applied Health Research and Care and through social media.

Trial registration: ISRCTN17942821; pre-results.

Keywords: COPD; primary care; self-management support.

Publication types

  • Multicenter Study
  • Pragmatic Clinical Trial

MeSH terms

  • Adaptation, Psychological*
  • Humans
  • Patient Education as Topic*
  • Physical Therapy Modalities
  • Primary Health Care / organization & administration
  • Prospective Studies
  • Psychotherapy, Group
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life
  • Research Design
  • Self Report
  • Self-Management / methods*
  • Single-Blind Method