PT  - JOURNAL ARTICLE
AU  - Fabienne Dobbels
AU  - Corina de Jong
AU  - Ellen Drost
AU  - Janneke Elberse
AU  - Chryssoula Feridou
AU  - Laura Jacobs
AU  - Roberto Rabinovich
AU  - Anja Frei
AU  - Milo A. Puhan
AU  - Willem I. de Boer
AU  - Thys van der Molen
AU  - Kate Williams
AU  - Hillary Pinnock
AU  - Thierry Troosters
AU  - Niklas Karlsson
AU  - Karoly Kulich
AU  - Katja Rüdell
AU  - the PROactive consortium
TI  - The PROactive innovative conceptual framework on physical activity
AID  - 10.1183/09031936.00004814
DP  - 2014 Nov 01
TA  - European Respiratory Journal
PG  - 1223--1233
VI  - 44
IP  - 5
4099  - http://erj.ersjournals.com/content/44/5/1223.short
4100  - http://erj.ersjournals.com/content/44/5/1223.full
SO  - Eur Respir J2014 Nov 01; 44
AB  - Although physical activity is considered an important therapeutic target in chronic obstructive pulmonary disease (COPD), what “physical activity” means to COPD patients and how their perspective is best measured is poorly understood. We designed a conceptual framework, guiding the development and content validation of two patient reported outcome (PRO) instruments on physical activity (PROactive PRO instruments). 116 patients from four European countries with diverse demographics and COPD phenotypes participated in three consecutive qualitative studies (63% male, age mean±sd 66±9 years, 35% Global Initiative for Chronic Obstructive Lung Disease stage III–IV). 23 interviews and eight focus groups (n = 54) identified the main themes and candidate items of the framework. 39 cognitive debriefings allowed the clarity of the items and instructions to be optimised. Three themes emerged, i.e. impact of COPD on amount of physical activity, symptoms experienced during physical activity, and adaptations made to facilitate physical activity. The themes were similar irrespective of country, demographic or disease characteristics. Iterative rounds of appraisal and refinement of candidate items resulted in 30 items with a daily recall period and 34 items with a 7-day recall period. For the first time, our approach provides comprehensive insight on physical activity from the COPD patients’ perspective. The PROactive PRO instruments’ content validity represents the pivotal basis for empirically based item reduction and validation. Conceptual framework as basis of PROactive PRO instruments to assess physical activity from COPD patient perspective http://ow.ly/ytJoS