P50 Facilitation of continued exercise via patient volunteers with chronic obstructive pulmonary disease (COPD) following a pulmonary rehabilitation programme: a feasibility study

IntroductionAfter pulmonary rehabilitation activity levels gradually decline, on average, back to baseline over 12–18 months. The NHS has highlighted the value of peer support for patients with chronic disease, but this has not been fully evaluated in patients with COPD. Therefore we designed an observational study with the aim of exploring and assessing an exercise maintenance programme with peer volunteer support over a 6-month period, in order to inform a future large-scale study.MethodsPatients were recruited from a 7-week outpatient community pulmonary rehabilitation programme. Six peer volunteers with COPD were trained and allocated up to six patients each. A fortnightly exercise maintenance programme was set up in one locality led by a physiotherapist & assistant. This was supported by a programme of home-based exercise, goal setting and feedback on activity levels. Peer volunteers met with their groups each month to encourage individual activity. The primary outcomes were participation levels and attendance rates; secondary outcomes were activity levels and health status. Qualitative interviews demonstrated the individual variance in exercise habits and motivations see Abstract P50 Table 1.Abstract P50 Table 1FacilitatorsConstraintsGroup providing social destinationSupportive environmentGroup creating a shared sense of belonging and acceptance enhanced by common goals, same condition and shared characteristicsMentors adoption of counsellor/support roleStaff generating trust through caring attitude and expertisePre-conditioned to exercisePersonally motivatedFostered through attendance at PACE rehabilitation programmeGroup social activity displacing exercise activityPersonal outlook and life events inhibiting motivation and ability to exerciseExercise programme: Lack of intensitySelf-directed, no external motivationLimited exercise equipmentFortnightly sessionsGroup vs individualSacrificing own needs for group cohesionResultsThere were 91 potential recruits who completed rehabilitation (13 didn't meet criteria, six became unwell). 37 refused to participate, citing reasons such as poor health, no difficulty in exercising or problems travelling to the centre. Of the 35 that agreed to participate, the attendance rate at exercise was 70%, and 30 completed the 6-month programme. In this group Shuttle Walking Test distances were maintained at 6 months (mean 313.2 m post-rehabilitation compared with 317.8 m at 6 months, p=NS), and Chronic Respiratory Diseas