Abstract
Introduction: Exacerbations and hospitalizations in patients with chronic obstructive pulmonary disease(COPD) represent a major health burden and the impact of early education and rehabilitation programs on readmission after an exacerbation are open to debate.
Objectives:To assess the effect of a two-month, home program (HP) based on education and exercise,implemented just after a severe exacerbations of COPD,on future hospital admissions and number of outpatients visits.
Methods: Following a case-control design,COPD patients who had just undergone treatment of an acute exacerbation were enrolled on to a multidisciplinary intervention HP that included education sessions and exercise training from the second day after discharge (I group), for a period of 8 weeks, and were compared with a non-intervention group which received usual care (UC group).Primary outcome was the rate of severe exacerbations and secondary outcome outpatients visits during a 6-month follow-up period.
Results: 10 patients underwent the program and 12 patients were included in the control group (I group mean [SD] age 72[7] years and FEV1after bronchodilator 43[11]% predicted; UC group 72[5] years, 45[17]% predicted, ns).7 patients were readmitted to hospital with an exacerbation in the UC group (58%) and 1 in the I group (10%)(p<0.05).The difference in the number of outpatients visits in both groups was not statistically significant (I group 1[IQR 0-2];UC group 0[IQR 0-1],ns).
Conclusions: A post-exacerbation multidisciplinary HP in COPD may reduce re-exacerbation events that require admission over a 6-month period, without a significant increase in the number of outpatient visits.
- © 2012 ERS