Helping you help yourself (HYHY) for people with mild breathlessness: A service evaluation in Wales

Abstract

Background Pulmonary rehabilitation (PR) is an evidence-based intervention which improves exercise capacity and quality of life (QoL) for patients with chronic obstructive pulmonary disease (COPD). Commonly, outpatient rehabilitation is available for patients with significant breathlessness (Medical Research Council (MRC) >3). This evaluation explored changes in exercise capacity and knowledge of condition and their relationship with the impact of COPD (CAT score) at baseline following a community exercise and education programme delivered by the British Lung Foundation (BLF) in people with mild breathlessness (MRC ≤2). Methods People with mild breathlessness, MRC ≤2, were recruited from GP surgeries, the BLF website and support groups. The 6-week Helping you help yourself (HYHY) programme included weekly exercise, education and social engagement. Participants were assessed at baseline using the COPD Assessment Tool (CAT), 6-minute walk test (6MWT), Bristol COPD Knowledge quiz (BKQ), and questions on self-management was assessed by questionnaire. After 6 weeks 6MWT, BKQ and self-management were assessed and related to CAT at baseline. The usefulness of the programme to participants was also assessed by questionnaire. Results In the 210 patients who completed assessments before and after HYHY, there was an increase in 6MWT distance, median (IQR) 60 (30–80)m and BKQ 3 (1–4) points (p <0.05), and most elements of self-management improved. Almost all participants considered HYHY useful (p <0.05). There was no relationship between baseline CAT score and change in outcome measures (p >0.05). Conclusion The results support the provision of community rehabilitation as an alternative to hospital-based interventions to support and promote self-management in people with mild breathlessness across the severity of disease burden as measured by CAT.