PURE PRIME: implementing Pulmonary Rehabilitation in Primary care - a randomized-controlled feasibility trial.

In 30 seconds

PURE PRIME was a randomized controlled feasibility trial testing pulmonary rehabilitation (PR) in private physiotherapy or exercise physiology practices for people with chronic respiratory disease. Participants were assigned to an 8-week, twice-weekly program or usual care. Of those randomized to the intervention group, 75% completed the program. Among participants who undertook PR, outcomes improved from baseline, including incremental shuttle walk distance (mean difference, 53.7; 95% CI, 37.8-69.6 meters). The authors concluded that delivery in private practices was feasible and safe, although some control-group participants also received the intervention because of trial logistics.

Key findings

• Of participants randomized to PR, 75% completed the intervention.
• Among those undertaking PR, incremental shuttle walk test performance improved by a mean 53.7 meters (95% CI, 37.8-69.6).
• Within-group changes included 4.7 more repetitions on the 1-minute sit-to-stand test (95% CI, 3.3-6.0) and improved St George's Respiratory Questionnaire scores (mean difference, -7.38; 95% CI, -12.23 to -2.54).
• One minor study-related adverse event occurred.

Why it matters

Access to pulmonary rehabilitation is limited, and private physiotherapy and exercise physiology practices may offer an additional setting for delivery. This feasibility trial found substantial completion and improvements in exercise capacity and patient-reported outcomes among participants who undertook the program, with one minor study-related adverse event. These findings support further consideration of community-based delivery while not establishing comparative effectiveness.

What to keep in mind

This was a feasibility trial, and trial logistics led some participants allocated to usual care to complete the intervention, limiting clean comparison between groups.