Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation 147 Physiotherapist recruitment Physiotherapists will be contacted through Chronic CareNet, a Dutch quality network of more than 3,500 primary care providers (physiotherapists, exercise therapists and dieticians) who specialize in treating patients with noncommunicable chronic conditions, including lung disease. By recruiting physiotherapists through Chronic CareNet, an attempt is made to recruit the most homogeneous group of physiotherapists possible; that is, they must all meet the quality standards, i.e., in terms of their own education, the use of clinimetrics, the use of guidelines. Physiotherapists will be invited to participate via an e-mail containing study information and an information folder about the PATCH tool. Physiotherapists will be followed up via telephone contact and e-mail. Patient recruitment Patients will be recruited from enrolled primary physiotherapy practices. By inviting patients who receive PR from physiotherapists who are members of Chronic CareNet, and who meet the inclusion and exclusion criteria, a study population is constituted that represents as closely as possible the ‘average’ patient with COPD in the Netherlands. E-mails or invitation letters with an expression of interest form, and a reply envelope will be sent on behalf of the physiotherapist to all eligible patients. Non-responders will be sent a reminder e-mail/letter after 2–3 weeks. Furthermore, physiotherapists will be asked to remind the non-responders when they are visiting the physiotherapy practice. Inclusion and exclusion criteria On expression of interest, all potentially eligible patients will be screened by the researcher by telephone for eligibility. Patients (³ 18 years) with COPD, with airflow limitation stage GOLD II-IV, who are in the maintenance phase (therapeutic treatment) of rehabilitation (have had at least 6 weeks of PR) [11], and having rehabilitation sessions once a week, will be eligible for inclusion. Also, patients must provide written informed consent. They will be informed that when they take part in the study, they will still be free to withdraw at any time, without giving a reason; their decision will not affect the usual care they receive. The exclusion criteria are homebased rehabilitation, patients eligible for maintenance treatment, and insufficient mastery of the Dutch language to complete the questionnaires. Self-management All patients receive usual care according to the Dutch KNGF Guideline COPD [11]. This includes determining the training frequency, intensity and duration of an exercise according to this guideline. With the introduction of more selfmanagement, clinically supervised exercise sessions are reduced by half at T0, and patients are instructed to complete additional unsupervised exercise with the intention that overall exercise frequency remains unchanged. In practice, this
RkJQdWJsaXNoZXIy MjY0ODMw