The IMPROVE cluster randomised controlled trial
Dr Emma Godfrey is a co-applicant on this NIHR HSDR funded research project run through the Department of Population Health Sciences.
Improving life quality in chronic obstructive pulmonary disease (COPD) by increasing uptake and completion of pulmonary rehabilitation with lay health workers: the IMPROVE cluster randomised controlled trial.
• Chronic obstructive pulmonary disease (COPD) is the most common lung disease caused by smoking. It affects more than a million people in the UK. COPD causes breathlessness, cough, and fatigue It is a major cause of emergency hospital admission in the NHS, with rates having changed little in 20 years. Pulmonary rehabilitation (PR) is the most effective treatment for the symptoms and disability of COPD, but for many patients referred to PR, rates of completion are only 40% due to poor uptake.
• IMPROVE trial: UK multi-centre cluster randomised controlled trial (RCT), to test the impact of employing a lay health workers (LHW) intervention on completion rates of Pulmonary Rehabilitation (PR) centres throughout England. PR centres (clusters) will be randomised to intervention (LHW + usual care) or control arms (usual care).
• Volunteer lay health workers will be recruited from among people with COPD, previously treated in the participating PR services. PR staff in services randomised to the intervention arm will be trained to work with volunteer lay LHWs. Training of PR teams and LHW will incorporate psychological theory and principles of behaviour change.
• Principal outcome will be rate of completion of PR in intervention sites compared to control sites.
• Process evaluation: Each element will be evaluated, including PR staff training, LHW training, intervention fidelity, and acceptability to patients, LHWs, and PR staff. Health economic evaluation will also be completed.