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@article{Brighton:2020:10.2147/COPD.S238680,
author = {Brighton, LJ and Evans, CJ and Man, WDC and Maddocks, M},
doi = {10.2147/COPD.S238680},
journal = {The International Journal of Chronic Obstructive Pulmonary Disease},
pages = {841--855},
title = {Improving exercise-based interventions for people living with both COPD and frailty: a realist review},
url = {http://dx.doi.org/10.2147/COPD.S238680},
volume = {15},
year = {2020}
}

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TY  - JOUR
AB  - Background: People living with both chronic obstructive pulmonary disease (COPD) and frailty have high potential to benefit from exercise-based interventions, including pulmonary rehabilitation, but face challenges completing them. Research to understand ways to optimise exercise-based interventions in this group is lacking. We aimed to understand how exercise-based interventions might improve outcomes for people living with both COPD and frailty.Methods: This realist review used database searches and handsearching until October 2019 to identify articles of relevance to exercise-based interventions for people living with COPD and frailty. A scoping search explored what is important about the context of living with COPD and frailty, and what mechanisms might be important in how exercise-based interventions result in their intended outcomes. Through discussion with stakeholders, the review scope was refined to areas deemed pertinent to improving care. We retained articles within this refined scope and identified additional articles through targeted handsearching. Data were extracted and synthesised in a narrative, prioritised by relevance and rigour.Results: Of 344 records identified, 35 were included in the review and 20 informed the final synthesis. Important contextual factors to consider included: negative beliefs about themselves and exercise-based interventions; heterogenous presentation and comorbidities; decreased reserves and multidimensional loss; and experiencing unpredictable health and disruptions. In these circumstances, mechanisms that may help maximise outcomes from exercise-based interventions included: trusting relationships; creating a shared understanding of needs; having the capacity to address multidimensional concerns; being able to individualise approaches to needs and priorities; and flexible approaches to intervention delivery. Mixed-methods research and explicit theorising were often absent.Conclusion: Building trusting relationships, unders
AU  - Brighton,LJ
AU  - Evans,CJ
AU  - Man,WDC
AU  - Maddocks,M
DO  - 10.2147/COPD.S238680
EP  - 855
PY  - 2020///
SN  - 1176-9106
SP  - 841
TI  - Improving exercise-based interventions for people living with both COPD and frailty: a realist review
T2  - The International Journal of Chronic Obstructive Pulmonary Disease
UR  - http://dx.doi.org/10.2147/COPD.S238680
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000527398400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://www.dovepress.com/improving-exercise-based-interventions-for-people-living-with-both-cop-peer-reviewed-fulltext-article-COPD
UR  - http://hdl.handle.net/10044/1/107319
VL  - 15
ER  -

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