Article

OBJECTIVE: To assess whether a maintenance integrated health care programme is
effective in improving functional and emotional dimensions of quality of life in
patients with chronic obstructive pulmonary disease (COPD) after a first pulmonary rehabilitation. DESIGN: Prospective controlled trial. SETTING: Three
rehabilitation centres and three patient self-help associations within a health
care network in France. SUBJECTS: Forty patients with moderate to severe COPD.
INTERVENTIONS: After a first four-week inpatient pulmonary rehabilitation
programme, patients took part in a maintenance integrated health care programme
or usual care for 12 months. MAIN MEASURES: The primary outcomes were the change
in functional and emotional dimensions of quality of life measured by the St
George's Respiratory Questionnaire (SGRQ), the brief World Health Organization
Quality of Life questionnaire (Brief-WHOQOL) and six specific questions using a
10-cm visual analogue scale. Secondary outcomes were change in exercise tolerance
measured by six-minute walking test and cycle exercise. RESULTS: At one year, the
maintenance intervention (n = 11) produced improvements in functional and
emotional dimensions scores of quality of life and exercise tolerance. Patients
in the usual aftercare group (n = 16) exhibited maintenance of functional
dimension scores of quality of life, but a clinically relevant decline in
emotional scores of quality of life and in six-minute walking distance one year
after the pulmonary rehabilitation. CONCLUSION: Patient self-help association
seems to be an innovative and efficient organizational structure to support
patients with COPD after pulmonary rehabilitation in real-life settings. A
distinction between emotional and functional dimensions of quality of life may
improve the design and evaluation of integrated health care programmes in
patients with COPD.

Langue : ANGLAIS