Use and impact of assistive devices in activities of daily living among adults with advanced respiratory disease: a secondary data analysis

PURPOSE: Disability in activities of daily living (ADLs) is highly prevalent among people with advanced respiratory disease. We aimed to describe the prevalence of assistive device use for basic ADLs and mobility and explore changes in independence following the uptake of a new assistive device. MATERIALS AND METHODS: Secondary data analysis of a longitudinal cohort study of 201 participants with advanced respiratory disease (cancer or non-cancer). Disability in ADLs and mobility was measured using the Barthel Index, Lawton Brody IADL Scale, and WHODAS-2.0. Assistive device use was assessed at monthly intervals for up to six months by self-report postal survey. Devices were categorised by ADL. Change in individual ADL items and WHODAS self-care and mobility scores were determined before, during and following use of a new assistive device. RESULTS: < 0.001). Sixty-six participants reported use of new assistive devices during follow-up. Across individual ADL items, significant improvements in disability were found following use of assistive devices for indoor mobility, domestic tasks, bathing and stairs or steps. CONCLUSIONS: Assistive device use is highly prevalent in people with advanced respiratory disease, increasing with disability in ADLs. Summary measures of ADL disability may lack meaningful sensitivity to change following uptake of assistive devices, especially when global improvement is not the desired outcome.