A three‐year follow‐up of a nurse‐led multidisciplinary pulmonary rehabilitation programme in primary health care: a quasi‐experimental study

Aims and objectives To investigate the effects of a nurse‐led multidisciplinary pulmonary rehabilitation programme conducted in primary health care on functional capacity, quality of life and exacerbation frequency over three years among patients with Chronic Obstructive Pulmonary Disease. Background Although Chronic Obstructive Pulmonary Disease is a chronic respiratory disease, it has been established that pulmonary rehabilitation has positive effects on patients' everyday functioning. However, the duration of these functional improvements, especially when the rehabilitation programmes are provided in primary health care settings, remains to be established. Design A quasi‐experimental design. Method Primary health care patients with Chronic Obstructive Pulmonary Disease (GOLD stages II and III) were included; 49 in the intervention group and 54 in the control group. The intervention comprised a six‐week pulmonary rehabilitation programme. Functional capacity was assessed using a six‐minute walking test and quality of life by the Clinical COPD Questionnaire at baseline, after one year and three years. Exacerbation frequency was calculated from one year before to three years after the programme. Results No significant differences between the groups were observed in the six‐minute walking‐test or the Clinical COPD Questionnaire after one year and three years. On average, there were significant improvements in the six‐minute walking‐test and the Clinical COPD Questionnaire from baseline to the one‐year follow‐up. Exacerbation frequency tended to decrease in the intervention group and increase in the control group (interaction test was p = 0·091) but increased again in both groups after three years. Conclusion There was no evidence of the benefit of the nurse‐led multidisciplinary pulmonary rehabilitation programme, although the exacerbation frequency tended to decrease in the intervention group after one year. There is a need for support and coaching at regular follow‐ups in primary health care. Relevance to clinical practice There is a need to support and coach patients with Chronic Obstructive Pulmonary Disease in primary health care by means of regular follow‐ups.