Evidence map›Paper›PMID 39076524›Full record

ArticleERJ open research2024

Comprehensive geriatric assessment for people with both COPD and frailty starting pulmonary rehabilitation: a mixed-methods feasibility trial.

Lisa Jane Brighton, Catherine J Evans, Morag Farquhar, Katherine Bristowe, Aleksandra Kata, Jade Higman, Margaret Ogden, Claire Nolan, Deokhee Yi, Wei Gao and 9 more

Abstract read
In one paragraph

Article in ERJ open research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Lisa Jane BrightonKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.ORCID https://orcid.org/0000-0003-0516-0102
Catherine J EvansKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
Morag FarquharUniversity of East Anglia, School of Health Sciences, Norwich, UK.
Katherine BristoweKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
Aleksandra KataKing's College London, Clinical Trials Unit, London, UK.
Jade HigmanKing's College London, Clinical Trials Unit, London, UK.
Margaret OgdenKing's College London, Cicely Saunders Institute Public Involvement Group, London, UK.
Claire NolanHarefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID https://orcid.org/0000-0001-9067-599X
Deokhee YiKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
Wei GaoKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.
Maria KoulopoulouKing's College Hospital NHS Foundation Trust, Pulmonary Rehabilitation, London, UK.
Sharmeen HasanKing's College Hospital NHS Foundation Trust, Department of Clinical Gerontology, London, UK.
Karen IngramHarefield Pulmonary Rehabilitation, Heart Lung and Critical Care Group, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Stuart ClarkeHarefield Pulmonary Rehabilitation, Heart Lung and Critical Care Group, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Kishan R ParmarDepartment of Geriatric Medicine, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK.
Eleni BaldwinDepartment of Geriatric Medicine, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK.
Claire J StevesKing's College London, Department of Twin Research and Genetic Epidemiology, London, UK.
William D-C ManHarefield Respiratory Research Group, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID https://orcid.org/0000-0002-3782-659X
Matthew MaddocksKing's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Many people with COPD experience frailty. Frailty increases risk of poor health outcomes, including non-completion of pulmonary rehabilitation. Integrated approaches to support people with COPD and frailty throughout and following rehabilitation are indicated. The aim of the present study was to determine the feasibility of conducting a randomised controlled trial of integrating comprehensive geriatric assessment (CGA) for people with COPD and frailty starting pulmonary rehabilitation. Methods: A multicentre mixed-methods randomised controlled feasibility trial ("Breathe Plus"; ISRCTN13051922) was carried out. People with COPD, aged ≥50 years, Clinical Frailty Scale ≥5 and referred for pulmonary rehabilitation were randomised 1:1 to usual pulmonary rehabilitation, or pulmonary rehabilitation plus CGA. Remote intervention delivery was used during COVID-19 restrictions. Outcomes (physical, psychosocial, service use) were measured at baseline, 90 and 180 days, alongside process data and qualitative interviews. Results: Recruitment stopped at 31 participants (mean±sd age 72.4±10.1 years, 68% Medical Research Council Dyspnoea Scale 4-5), due to COVID-19-related disruptions. Recruitment (46% eligible recruited) and retention (87% at 90- and 180-day follow-up) were acceptable. CGAs occurred on average 60.5 days post-randomisation (range 8-129) and prompted 46 individual care recommendations (median 3 per participant, range 0-12), 65% of which were implemented during follow-up. The most common domains addressed during CGA were nutrition and cardiovascular health. Participants valued the holistic approach of CGA but questioned the optimal time to introduce it. Conclusion: Integrating CGA alongside pulmonary rehabilitation is feasible and identifies unmet multidimensional need in people with COPD and frailty. Given challenges around timing and inclusivity, the integration of geriatric and respiratory care should not be limited to rehabilitation services.

Identifiers

PMID39076524
PMCPMC11284595

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.