Pulmonary rehabilitation in bronchiectasis: a propensity matched study
- Suhani Patel1,2,*,
- Aaron D. Cole2,*,
- Claire M. Nolan1,2,3,
- Ruth E. Barker1,2,
- Sarah E. Jones1,2,
- Samantha Kon1,3,
- Julius Cairn4,
- Michael Loebinger3,5,
- Robert Wilson3,5 and
- William D.-C. Man1,2,3,4
- 1Harefield Pulmonary Rehabilitation and Muscle Research Group, Royal Brompton & Harefield NHS Foundation Trust, UK
- 2Harefield Pulmonary Rehabilitation Unit, Royal Brompton & Harefield NHS Foundation Trust, UK
- 3National Heart and Lung Institute, Imperial College London, UK
- 4Department of Respiratory Medicine, Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust, UK
- 5Host Defence Unit, Royal Brompton & Harefield NHS Foundation Trust, UK
- Ms Suhani Patel, Research Respiratory Physiologist, Harefield Pulmonary Rehabilitation and Muscle Research Group, Harefield Hospital, Harefield UB9 6JH, UK; E-mail: s.patel1{at}rbht.nhs.uk
* Contributed equally
Abstract
Introduction: International guidelines recommend pulmonary rehabilitation (PR) for patients with bronchiectasis, supported by small trials and data extrapolated from chronic obstructive pulmonary disease (COPD). However, it is unknown whether real-life data on completion rates and response to PR are similar between patients with bronchiectasis and COPD.
Methods: Using propensity score matching, 213 consecutive patients with bronchiectasis referred for a supervised PR programme were matched 1:1 with a control group of 213 patients with COPD. Completion rates, changes in incremental shuttle walk (ISW) and Chronic Respiratory Questionnaire (CRQ) with PR were compared between groups.
Results: Completion rate was the same in both groups (74%). Improvements in ISW and most domains of CRQ with PR were similar between the bronchiectasis and COPD groups (ISW: 70 versus 63 metres; CRQ-Dyspnoea: 4.8 versus 5.3; CRQ-Emotion: 3.5 versus 4.6; CRQ-Mastery: 2.3 versus 2.9; all p>0.20). However, improvements in CRQ-Fatigue with PR were greater in the COPD group (bronchiectasis: 2.1 versus COPD: 3.3; p=0.02).
Conclusion: In a real-life, propensity-matched control study, patients with bronchiectasis show similar completion rates and improvements in exercise and health status outcomes as patients with COPD. This supports the routine clinical provision of PR to patients with bronchiectasis.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Miss. Patel has nothing to disclose.
Conflict of interest: Mr. Cole has nothing to disclose.
Conflict of interest: Dr. Nolan has nothing to disclose.
Conflict of interest: Dr. Barker has nothing to disclose.
Conflict of interest: Dr. Jones has nothing to disclose.
Conflict of interest: Dr. Kon has nothing to disclose.
Conflict of interest: Dr. Cairn has nothing to disclose.
Conflict of interest: Dr. Loebinger has nothing to disclose.
Conflict of interest: Dr. Wilson has nothing to disclose.
Conflict of interest: Dr. Man reports grants from Pfizer, non-financial support from GSK, personal fees from Mundipharma, personal fees from Novartis, outside the submitted work.
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- Copyright ©ERS 2018