Abstract
Introduction In this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence.
Methods PHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (Stage of Change Visual Analogue Scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]), and confidence (Perceived Competence Scale [PCS]) to engage in PA.
Results PA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1 was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS.
Conclusion Our study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in changing the mechanisms of change targeted by the intervention.
Footnotes
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Conflict of interest: Dr. Bourbeau reports grants from McGill University, grants from Research Institute of the McGill University Health Centre, grants from GlaxoSmithKline, grants from Aerocrine, grants from Canadian Respiratory Research Network (CRRN) – Canadian Institute of Health Research (CIHR), grants from Almirall, grants from AstraZeneca, grants from Boehringer Ingelheim, grants from GlaxoSmithKline, grants from Novartis, outside the submitted work.
Conflict of interest: Maria Sedeno is an employee of RESPIPLUS and, in this salaried position, works with a variety of companies and receives no payment or honoraria directly from them for services rendered.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Troosters reports other from Boehringer Ingelheim, other from AstraZeneca, grants from PROactive, during the conduct of the study; grants from Research Foundation Flanders, outside the submitted work.
Conflict of interest: Dr. Hamilton is an employee of Boehringer Ingelheim (Canada) Ltd.
Conflict of interest: Dr. De Sousa is an employee of Boehringer Ingelheim.
Conflict of interest: Dr. Maltais reports personal fees and non-financial support from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Novartis, and Griffols, outside the submitted work.
Conflict of interest: Dr. Erzen has nothing to disclose.
Conflict of interest: Dr. Lavoie reports other from Abbvie, Boehringer Ingelheim, Janssen, AstraZeneca, Astellas, Bayer, Novartis, and Mundipharma, outside the submitted work.
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- Received July 28, 2020.
- Accepted December 16, 2020.
- Copyright ©ERS 2021
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