Well Being and Rehabilitation in Chronically Ill Patients: Structured Patient Education and Physical Exercise

Study Overview
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Brief Summary
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This study addresses self management and maintenance of health through evaluation of a program of patient education in combination with physical training and with a structured follow-up. It is hypothesized that such a program will: improve quality of life, physical functioning, coping in everyday-life reduce hospitalization and (re-)admissions for patients with chronic disease, reduce consumption of home care services and can increase consumption of general practice and physiotherapy services in primary health care. improve patient satisfaction and health care providers satisfaction

Detailed Description
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Patients with chronically, long-lasting illness, have complex needs for treatment and care, which none of the service providers can fulfill on their own. Both patients and their relatives are in danger of experiencing severe lack of quality. Integrated care path programs are increasingly put into use. There is insufficient research-based documentation of the effect of such care paths. The available documentation of different integrated care paths emphasizes early mobilization and discharge, rehabilitation in familiar surroundings, more effective communication and exchange of competence between the different service providers and educational self-management for patients as main elements in order to expect effect. There are no studies that evaluate the effect of quality of life, functional skills and personal coping if group-based educational self management is combined with physical exercise and patients with different chronically illnesses participate in the same group.

Official Title
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Structured Patient Education in Combination With Physical Exercise as Part of the Integrated Care to Chronically Ill Patients With Chronic Obstructive Pulmonary Disease, Heart Failure and Stroke. A Randomized Controlled Intervention Trial.

Conditions
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Chronic Obstructive Pulmonary Disease, Heart Failure, Stroke

Intervention / Treatment
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* Behavioral: Self management education programme
* Behavioral: exercise only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 45 years of age or more Living at home Capable of active participation in a group setting Walking distance within 550 meter in 6 minutes Chronic obstructive pulmonary disease (COPD) I-III Chronic heart disease I-III Stroke(0-2 on Modified Rankin Scale) Exclusion Criteria: Speaking and language problems or other substantial communication problems Unstable medical or social situation Participation in another science study

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: exercise and education<br>Supervised physical exercise in groups, plus a self management education programme (patient education). | Behavioral: Self management education programme<br>* The structured patient educational self - management programme consists of 6 weekly sessions à 2 hours. The educational programme will take place prior to one of the two weekly training sessions. After the initial period of 8 weeks participants are encouraged to practicing self- management on their own for a period of 9 months. They receive,in addition to standard follow - up, an offer of extra follow - up consisting of regular contact with their group supervisors in primary health care. During the last month of the intervention year educational self - management will be offered twice and focus on themes that the participants wish to refresh.<br>|
| Active Comparator: exercise only<br>Supervised physical exercise in groups. | Behavioral: exercise only<br>* 6 week waiting list, followed by two weekly training sessions. After the initial period of 8 weeks participants are encouraged to practicing self- management on their own for a period of 9 months. They receive,in addition to standard follow - up, an offer of extra follow - up consisting of regular contact with their group supervisors in primary health care.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health related quality of life |  | One year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sustainability of the physiological effects of muscular training (6 Minutes Walk) |  | One year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic obstructive pulmonary disease, Heart failure, Stroke, quality of life, self management education, physical exercise, primary health care