Chronic obstructive pulmonary disease (COPD) has been targeted nationally as a "priority" condition for which multiple strategies are needed to improve outcomes. The absolute number of years lost to disability due to COPD exceeds the years of life lost due to premature death. There is strong evidence that pulmonary rehabilitation (PR) improves outcomes and is cost saving, but fewer than 2% of patients have access to these programs. New methods of PR are needed to increase access of patients with COPD to these established benefits. To address this gap we propose a novel physical activity self-management (PASM) program based on an evidence-based physical activity intervention designed to increase physical activity and quality of life. Key components of the program include tailored telephone counseling, a workbook, and computer- assisted telephone follow-up.
Our specific aims are: 1) To implement a PASM program for patients with COPD. 2) To conduct an 18-month, randomized, controlled, single-blind trial comparing PASM (n=150) to usual care (UC) (n=150) to determine the effectiveness on functional performance and health status. 3) To determine the costeffectiveness of the HBPR intervention. We will test the following two hypotheses: 1) Patients with COPD who receive PASM have clinically and statistically significant improvements in functional performance (i.e., Chronic Respiratory Questionnaire [CRQ] dyspnea domain and 6-minute walk) compared to patients who receive UC. 2) The PASM program is more cost-effective compared to the UC. This project will be conducted in east Texas by an experienced, multi-disciplinary research team with expertise in pulmonary medicine, epidemiology, clinical research, health psychology, exercise science, biostatistics, and health economics from the University of Texas Health Center at Tyler, the University of Texas at Tyler, the Cooper Aerobics Center, and the University of North Texas Health Sciences Center. The project addresses a major gap in the current management of COPD and may provide a novel, cost-effective strategy for improving functional performance and health status.

Public Health Relevance

Chronic obstructive pulmonary disease (COPD) is a common and growing condition worldwide that causes substantial disability. While there is strong evidence that pulmonary rehabilitation can improve health status of patients with COPD and is cost saving, few patients have access to these programs. In this application we propose to implement and test a home-based program to increase patients'access to the benefits of pulmonary rehabilitation by using an evidence- based intervention designed to increase physical activity and improve health status.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18HL092955-05
Application #
8474826
Study Section
Special Emphasis Panel (ZHL1-CSR-Z (M1))
Program Officer
Freemer, Michelle M,
Project Start
2009-07-17
Project End
2014-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
5
Fiscal Year
2013
Total Cost
$573,353
Indirect Cost
$95,274
Name
University of Texas Health Center at Tyler
Department
None
Type
Organized Research Units
DUNS #
800772337
City
Tyler
State
TX
Country
United States
Zip Code
75708
Jackson, Bradford E; Coultas, David B; Ashmore, Jamile et al. (2014) Domain-specific self-efficacy is associated with measures of functional capacity and quality of life among patients with moderate to severe chronic obstructive pulmonary disease. Ann Am Thorac Soc 11:310-5
Ashmore, Jamile; Russo, Rennie; Peoples, Jennifer et al. (2013) Chronic obstructive pulmonary disease self-management activation research trial (COPD-SMART): design and methods. Contemp Clin Trials 35:77-86
Jackson, Bradford E; Coultas, David B; Suzuki, Sumihiro et al. (2013) Rural-urban disparities in quality of life among patients with COPD. J Rural Health 29 Suppl 1:s62-9
Jackson, Bradford E; Suzuki, Sumihiro; Coultas, David et al. (2013) Chronic obstructive pulmonary disease and health-related quality of life in the 2009 Texas Behavioral Risk Factor survey. Health Educ Behav 40:469-79
Jackson, Bradford E; Suzuki, Sumihiro; Lo, Kaming et al. (2011) Geographic disparity in COPD hospitalization rates among the Texas population. Respir Med 105:734-9
Jackson, Bradford E; Suzuki, Sumihiro; Coultas, David et al. (2011) Safety-net facilities and hospitalization rates of chronic obstructive pulmonary disease: a cross-sectional analysis of the 2007 Texas Health Care Information Council inpatient data. Int J Chron Obstruct Pulmon Dis 6:563-71