Impact of a behavioral-based intervention on inspiratory muscle training prescription by a multidisciplinary team

Authors


  • Disclosures: The authors report that this study was supported by the Canadian Respiratory Health Professionals of the Lung Association, Canadian Institutes of Health Research, American College of Rheumatology Research & Education Foundation, The Arthritis Society, Canada Research Chairs.

Abstract

Introduction:

Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR).

Methods:

Six hospital PR programs were randomly assigned to a behavioral- or information-based intervention. Both interventions provided evidence supporting IMT and its prescription details. However, the behavioral-based intervention focused on barriers and challenges to IMT prescription informed by a nationwide survey and the theory of planned behavior (TPB). It included hands-on practice and content, in part, was driven by learners' questions. In contrast, the information-based intervention delivered information in a typical didactic education session followed by a demonstration and question period. It was supplemented with evidence-based research articles. The primary outcome was the change in prescription rate of IMT for COPD patients by determining the difference during the 6 months preceding compared to the 6 months during the interventions.

Results:

Sixty-one health professionals and 488 COPD outpatients within 6 PR programs participated. No COPD patients were prescribed IMT at any of the sites during the 6-month preintervention phase. The behavioral-based intervention resulted in an IMT prescription rate of 10.2% to people with COPD, whereas the information-based intervention resulted in no IMT prescriptions.

Discussion:

A behavioral-based intervention that is based on TPB and addresses challenges identified by health professionals is more effective than a traditional lecture approach to increase health professionals' prescription of IMT for patients with COPD.

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