https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/26 2026-05-23T02:27:44Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/490 Title: Home-based pulmonary rehabilitation early after hospitalisation in COPD (early HomeBase): protocol for a randomised controlled trial Authors: Cox, N. S; Lahham, A.; McDonald, C. F.; Mahal, A.; O'Halloran, P.; Hepworth, G.; Spencer, L.; McNamara, R. J.; Bondarenko, J.; Macdonald, H.; Gavin, S.; Burge, A. T.; Le Maitre, C.; van Hilton, S.; Santos, M.; Crute, H.; Byrne, M.; Boursinos, H.; Broe, J.; Corbett, M.; Marceau, T.; Warrick, B.; Boote, C.; Melinz, J.; Holland, A. E. Abstract: Introduction: Chronic obstructive pulmonary disease (COPD) is characterised by exacerbations of respiratory disease, frequently requiring hospital admission. Pulmonary rehabilitation can reduce the likelihood of future hospitalisation, but programme uptake is poor. This study aims to compare hospital readmission rates, clinical outcomes and costs between people with COPD who undertake a home-based programme of pulmonary rehabilitation commenced early (within 2 weeks) of hospital discharge with usual care. Methods: A multisite randomised controlled trial, powered for superiority, will be conducted in Australia. Eligible patients admitted to one of the participating sites for an exacerbation of COPD will be invited to participate. Participants will be randomised 1:1. Intervention group participants will undertake an 8-week programme of home-based pulmonary rehabilitation commencing within 2 weeks of hospital discharge. Control group participants will receive usual care and a weekly phone call for attention control. Outcomes will be measured by a blinded assessor at baseline, after the intervention (week 9-10 posthospital discharge), and at 12 months follow-up. The primary outcome is hospital readmission at 12 months follow-up. Ethics and dissemination: Human Research Ethics approval for all sites provided by Alfred Health (Project 51216). Findings will be published in peer-reviewed journals, conferences and lay publications. Trial registration number: ACTRN12619001122145. Keywords: COPD exacerbations; exercise; pulmonary rehabilitation. 2021-11-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/442 Title: 'Tired, afraid, breathless … .' An international survey of the exercise experience for people living with pulmonary hypertension Authors: Chia, K. S. W.; Brown, K.; Kotlyar, E.; Wong, P. K. K.; Faux, S. G.; Shiner, C. T. Abstract: Patients with pulmonary hypertension are more sedentary than the general population, but attitudes and experiences that may influence their exercise behaviour remain poorly understood. This study identified patterns of behaviour, attitudes towards exercise, barriers and enablers of exercise for people living with pulmonary hypertension. Accessibility of rehabilitation services from a patient perspective was also explored. A voluntary, international survey of people living with pulmonary hypertension was conducted, with mixed quantitative and qualitative data collection. Data from 187 participants in 19 countries were included in the analyses. In total, 52% (95/183) of people with pulmonary hypertension reported that they attempted to engage in regular physical activity. This was less than the proportion who did so prior to diagnosis (61%, 112/184, p = 0.006) and was accompanied by uncertainty and anxiety about exercise. In total, 63% (113/180) of the cohort reported experiencing previous adverse events while exercising, which was associated with a greater likelihood of ongoing exercise concerns and anxiety. Fear, frustration and uncertainty about exercise were noted as common barriers to engaging in exercise with pulmonary hypertension. Other barriers to exercise included intrinsic factors such as debilitating breathlessness and fatigue, and external factors such as cost and access to appropriate services. Most respondents (76%, 128/169) did not have access to a multi-disciplinary rehabilitation service, although an overwhelming majority (92%, 159/172) reported that this would be helpful. Respondents rated education; a supervised, structured exercise programme; and psychology input as the most important components of a multi-disciplinary rehabilitation service for pulmonary hypertension. Health professionals must work together with consumers to co-design rehabilitation services that will facilitate exercise and increased activity for people living with pulmonary hypertension. 2020-11-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/440 Title: Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol Authors: Chia, K. S. W.; Faux, S. G.; Wong, P. K. K.; Holloway, C.; Assareh, H.; McLaughlan, C. S.; Kotlyar, E. Abstract: Introduction: Pulmonary hypertension (PH) is a potentially life-threatening condition characterised by elevated pulmonary artery pressure. Early stage PH patients are often asymptomatic. Disease progression is associated with impairment of right ventricular function and progressive dyspnoea. Current guidelines recommend exercise training (grade IIa, level B). However, many questions remain regarding the mechanisms of improvement, intensity of supervision and optimal frequency, duration and intensity of exercise. This study will assess the effect of an outpatient rehabilitation programme on haemodynamics and cardiac right ventricular function in patients with pulmonary arterial hypertension (PAH), a subgroup of PH. Methods and analysis: This randomised controlled trial involves both a major urban tertiary and smaller regional hospital in New South Wales, Australia. The intervention will compare an outpatient rehabilitation programme with a control group (home exercise programme). Participants will be stable on oral PAH-specific therapy. The primary outcome measure will be right ventricular ejection fraction measured by cardiac MRI. Secondary outcomes will include haemodynamics measured by right heart catheterisation, endurance, functional capacity, health-related quality of life questionnaires and biomarkers of cardiac function and inflammation. Ethics approval and dissemination: Ethical approval has been granted by St Vincent's Hospital, Sydney (HREC/14/SVH/341). Results of this study will be disseminated through presentation at scientific conferences and in scientific journals. 2017-02-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/384 Title: Serendipitous use of terlipressin Authors: Sanghi, K. Abstract: No abstract available. 2016-01-01T00:00:00Z