Article

OBJECTIVE: To determine the effectiveness of a multidisciplinary, outpatient
pulmonary rehabilitation (PR) program in patients with severe and very severe
chronic obstructive pulmonary disease (COPD). PR is recommended in advanced COPD,
but there is limited evidence on the effectiveness of PR in reducing health care
resources when applied in outpatients. DESIGN: Before and after intervention, a
prospective research trial of patients enrolled in a PR program. SETTING:
Outpatient respiratory department in a specialized hospital. PARTICIPANTS: We
considered prospectively 82 consecutive patients with advanced COPD and finally
studied 72 patients who completed the PR intensive phase. INTERVENTION: PR
program. MAIN OUTCOME MEASURES: The effectiveness of this PR program was assessed
by comparing health resources use from the year before and the year after PR.
Clinical variables including dyspnea; the body mass index, obstruction, dyspnea,
exercise capacity (BODE) index; and the Chronic Respiratory Questionnaire and
health resources use including the number of exacerbations, the number of
hospitalizations, and days of hospitalization. RESULTS: Patients had a forced
expiratory volume in the first second percentage predicted (mean +/- SD) of
33.0+/-9.8 and a BODE index of 5.0+/-2.0. Significant improvements after PR were
found in dyspnea, exercise capacity, and quality of life and on the BODE index
(P<.05). Compared with the 12 months before PR, there were also significant
reductions during the year after PR on exacerbations (3.4+/-3.5 vs 1.9+/-2.0,
P=.002), hospitalizations (2.4+/-2.0 vs 0.9+/-1.2, P<.001), and days of
hospitalization (36.1+/-32.7 vs 16.1+/-31.3, P<.001) (ie, a reduction of 44%,
63%, and 55%, respectively; all P<.05). CONCLUSIONS: We conclude that a
multidisciplinary, outpatient PR program substantially reduces health resources
use in patients with severe and very severe COPD.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS