TY - JOUR
T1 - Predictors of increasing disability in activities of daily living among people with advanced respiratory disease
T2 - a multi-site prospective cohort study, England UK
AU - Fettes, Lucy
AU - Bayly, Joanne
AU - Chukwusa, Emeka
AU - Ashford, Stephen
AU - Higginson, Irene
AU - Maddocks, Matthew
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. M. M. is funded by an NIHR Career Development Fellowship (CDF-2017-10-009), I. J. H. is an NIHR Senior Investigator Emeritus. I. J. H., M. M. and E. C. are supported by the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. I. J. H. leads the Palliative and End of Life Care theme of the NIHR ARC South London and co-leads the national theme.
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023/12/10
Y1 - 2023/12/10
N2 - PURPOSE: Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease.METHOD: Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton-Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs.FINDINGS: Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (
n = 110), COPD (
n = 72), and ILD (
n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14-1⋅74],
p = 0⋅002).
CONCLUSION: Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs.
AB - PURPOSE: Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease.METHOD: Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton-Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs.FINDINGS: Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (
n = 110), COPD (
n = 72), and ILD (
n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14-1⋅74],
p = 0⋅002).
CONCLUSION: Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs.
KW - Activities of daily living
KW - advanced cancer
KW - disability
KW - palliative care
KW - rehabilitation
KW - respiratory disease
UR - http://www.scopus.com/inward/record.url?scp=85180213621&partnerID=8YFLogxK
U2 - 10.1080/09638288.2023.2288673
DO - 10.1080/09638288.2023.2288673
M3 - Article
C2 - 38073190
AN - SCOPUS:85180213621
SN - 0963-8288
SP - 1
EP - 10
JO - Disability and Rehabilitation
JF - Disability and Rehabilitation
ER -