RT Journal Article
SR Electronic
T1 Outpatient pulmonary rehabilitation following acute exacerbations of COPD
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 423
OP 428
DO 10.1136/thx.2009.124164
VO 65
IS 5
A1 Seymour, John M
A1 Moore, Lauren
A1 Jolley, Caroline J
A1 Ward, Katie
A1 Creasey, Jackie
A1 Steier, Joerg S
A1 Yung, Bernard
A1 Man, William D-C
A1 Hart, Nicholas
A1 Polkey, Michael I
A1 Moxham, John
YR 2010
UL http://thorax.bmj.com/content/65/5/423.abstract
AB Background Exacerbations of chronic obstructive pulmonary disease (COPD) are characterised by increased dyspnoea, reduced quality of life and muscle weakness. Re-exacerbation and hospital admission are common. Pulmonary rehabilitation (PR) administered after hospital admission for an exacerbation can improve quality of life and exercise capacity.Objective To determine whether outpatient post-exacerbation PR (PEPR) could reduce subsequent hospital admission episodes.Methods Patients admitted to hospital for an exacerbation of COPD were randomised to receive either usual follow-up care (UC) or PEPR after discharge. Hospital admission and emergency department attendances for COPD exacerbations were recorded over a 3-month period and analysed on an intention-to-treat basis. Secondary outcomes included exercise capacity and quadriceps strength.Results 60 patients underwent concealed randomisation at the time of their hospital discharge (UC: n=30, mean (SD) age 65 (10) years, forced expiratory volume in 1 s (FEV1) 52 (22)% predicted; PEPR: n=30, 67(10) years, 52 (20)% predicted). The proportion of patients re-admitted to hospital with an exacerbation was 33% in the UC group compared with 7% in those receiving PEPR (OR 0.15, 95% CI 0.03 to 0.72, p=0.02). The proportion of patients that experienced an exacerbation resulting in an unplanned hospital attendance (either admission or review and discharge from the emergency department) was 57% in the UC group and 27% in those receiving PEPR (OR 0.28, 95% CI 0.10 to 0.82, p=0.02).Conclusions Post-exacerbation rehabilitation in COPD can reduce re-exacerbation events that require admission or hospital attendance over a 3-month period.Clinical Trials Registration Number NCT00557115.