{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:16:29Z","timestamp":1791263789089,"version":"4.1.0"},"reference-count":51,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T00:00:00Z","timestamp":1649548800000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Medical Research Future Fund (MRF1176491)"],"award-info":[{"award-number":["Medical Research Future Fund (MRF1176491)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,18]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is compelling evidence that either centre-based or home-based pulmonary rehabilitation improves clinical outcomes in chronic obstructive pulmonary disease (COPD). There are known health service and personal barriers which prevent potentially eligible patients from accessing the benefits of pulmonary rehabilitation. The aim of this hybrid effectiveness-implementation trial is to examine the effects of offering patients a choice of pulmonary rehabilitation locations (home or centre) compared with offering only the traditional centre-based model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method and analysis<\/jats:title>\n                    <jats:p>This is a two-arm cluster randomised, controlled, assessor-blinded trial of 14 centre-based pulmonary rehabilitation services allocated to intervention (offering choice of home-based or centre-based pulmonary rehabilitation) or control (continuing to offer centre-based pulmonary rehabilitation only), stratified by centre-based programme setting (hospital vs non-hospital). 490 participants with COPD will be recruited. Centre-based pulmonary rehabilitation will be delivered according to best practice guidelines including supervised exercise training for 8 weeks. At intervention sites, the home-based pulmonary rehabilitation will be delivered according to an established 8-week model, comprising of one home visit, unsupervised exercise training and telephone calls that build motivation for exercise participation and facilitate self-management. The primary outcome is all-cause, unplanned hospitalisations in the 12 months following rehabilitation. Secondary outcomes include programme completion rates and measurements of 6-minute walk distance, chronic respiratory questionnaire, EQ-5D-5L, dyspnoea-12, physical activity and sedentary time at the end of rehabilitation and 12 months following rehabilitation.<\/jats:p>\n                    <jats:p>Direct healthcare costs, indirect costs and changes in EQ-5D-5L will be used to evaluate cost-effectiveness. A process evaluation will be undertaken to understand how the choice model is implemented and explore sustainability beyond the clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Alfred Hospital Ethics Committee has approved this protocol. The trial findings will be published in peer-reviewed journals, submitted for presentation at conferences and disseminated to patients across Australia with support from national lung charities and societies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04217330\">NCT04217330<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057311","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T12:13:05Z","timestamp":1649679185000},"page":"e057311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Implementing a choice of pulmonary rehabilitation models in chronic obstructive pulmonary disease (HomeBase2 trial): protocol for a cluster randomised controlled trial"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04217330","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2061-845X","authenticated-orcid":false,"given":"Anne E","family":"Holland","sequence":"first","affiliation":[{"name":"Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Institute for Breathing and Sleep, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1689-8065","authenticated-orcid":false,"given":"Arwel W","family":"Jones","sequence":"additional","affiliation":[{"name":"Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Mahal","sequence":"additional","affiliation":[{"name":"The Nossal Global Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2066-8345","authenticated-orcid":false,"given":"Natasha A","family":"Lannin","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Allied Health (Occupational Therapy), Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-1028","authenticated-orcid":false,"given":"Narelle","family":"Cox","sequence":"additional","affiliation":[{"name":"Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Institute for Breathing and Sleep, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Hepworth","sequence":"additional","affiliation":[{"name":"Statistical Consulting Centre, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"O'Halloran","sequence":"additional","affiliation":[{"name":"Department of Public Health, La Trobe University, Bundoora, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6481-3391","authenticated-orcid":false,"given":"Christine F","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia"},{"name":"Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"2025120618044139000_12.4.e057311.1","unstructured":"Global strategy for the diagnosis, management, and prevention of COPD 2021 report, global initiative for chronic obstructive lung disease (gold). 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