TY - JOUR
T1 - Patient-centred rehabilitation for non-communicable disease in a low-resource setting: Study protocol for a feasibility and proof-of-concept randomised clinical trial
AU - Heine, Martin
AU - Fell, Brittany Leigh
AU - Robinson, Ashleigh
AU - Abbas, Mumtaz
AU - Derman, Wayne
AU - Hanekom, Susan
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Introduction Non-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. However, evidence for the effectiveness of rehabilitation for NCDs originates predominantly from high-income countries. Despite the disproportionate disease burden in low-resourced settings, and due to the complex context and constraints in these settings, the delivery and study of evidence-based rehabilitation treatment in a low-resource setting is poorly understood. This study aims to test the design, methodology and feasibility of a minimalistic, patient-centred, rehabilitation programme for patients with NCD specifically designed for and conducted in a low-resource setting. Methods and analysis Stable patients with cancer, cardiovascular disease, chronic respiratory disease and/or diabetes mellitus will be recruited over the course of 1 year from a provincial day hospital located in an urban, low-resourced setting (Bishop Lavis, Cape Town, South Africa). A postponed information model will be adopted to allocate patients to a 6-week, group-based, individualised, patient-centred rehabilitation programme consisting of multimodal exercise, exercise education and health education; or usual care (ie, no care). Outcomes include feasibility measures, treatment fidelity, functional capacity (eg, 6 min walking test), physical activity level, health-related quality of life and a patient-perspective economic evaluation. Outcomes are assessed by a blinded assessor at baseline, postintervention and 8-week follow-up. Mixed-method analyses will be conducted to inform future research. Ethics and dissemination This study has been approved by the Health Research and Ethics Council, Stellenbosch University (M17/09/031). Information gathered in this research will be published in peer-reviewed journals, presented at national and international conferences, as well as local stakeholders. Trial registration number PACTR201807847711940; Pre-results.
AB - Introduction Non-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. However, evidence for the effectiveness of rehabilitation for NCDs originates predominantly from high-income countries. Despite the disproportionate disease burden in low-resourced settings, and due to the complex context and constraints in these settings, the delivery and study of evidence-based rehabilitation treatment in a low-resource setting is poorly understood. This study aims to test the design, methodology and feasibility of a minimalistic, patient-centred, rehabilitation programme for patients with NCD specifically designed for and conducted in a low-resource setting. Methods and analysis Stable patients with cancer, cardiovascular disease, chronic respiratory disease and/or diabetes mellitus will be recruited over the course of 1 year from a provincial day hospital located in an urban, low-resourced setting (Bishop Lavis, Cape Town, South Africa). A postponed information model will be adopted to allocate patients to a 6-week, group-based, individualised, patient-centred rehabilitation programme consisting of multimodal exercise, exercise education and health education; or usual care (ie, no care). Outcomes include feasibility measures, treatment fidelity, functional capacity (eg, 6 min walking test), physical activity level, health-related quality of life and a patient-perspective economic evaluation. Outcomes are assessed by a blinded assessor at baseline, postintervention and 8-week follow-up. Mixed-method analyses will be conducted to inform future research. Ethics and dissemination This study has been approved by the Health Research and Ethics Council, Stellenbosch University (M17/09/031). Information gathered in this research will be published in peer-reviewed journals, presented at national and international conferences, as well as local stakeholders. Trial registration number PACTR201807847711940; Pre-results.
KW - cardiovascular diseases
KW - chronic obstructive
KW - developing countries
KW - diabetes mellitus
KW - feasibility studies
KW - neoplasms
KW - noncommunicable diseases
KW - pulmonary disease
KW - randomised controlled trial
KW - rehabilitation
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064764287&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30975678
U2 - https://doi.org/10.1136/bmjopen-2018-025732
DO - https://doi.org/10.1136/bmjopen-2018-025732
M3 - Article
C2 - 30975678
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 4
M1 - e025732
ER -