Chest
Volume 124, Issue 1, July 2003, Pages 94-97
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Clinical Investigations
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A Simple Pulmonary Rehabilitation Program Improves Health Outcomes and Reduces Hospital Utilization in Patients With COPD

https://doi.org/10.1378/chest.124.1.94Get rights and content

Study objectives

A prospective longitudinal study to investigate if a simple outpatient-based pulmonary rehabilitation program (PRP) can improve health outcome and hospital utilization in patients with COPD.

Patients

Patients with COPD and FEV1 < 60% predicted.

Setting

Outpatient physiotherapy department at a district general hospital (Fairfield Hospital, Sydney, Australia).

Intervention

Completion of a simple PRP.

Results

Thirty-six patients with COPD completed the PRP. Improved exercise endurance (mean ± SD 6-min walking distance increased from 333 ± 76 to 423 ± 107 m [p < 0.001]), reduced dyspnea scale, and improved quality-of-life measurements were found. There was no improvement in lung functions (FEV1 preprogram mean, 0.97 ± 0.43 L; postprogram mean, 0.96 ± 0.42 L). In the 12 months following completion of program, hospitalization and length of stay were reduced compared to prior to starting the program (preprogram, 7.4 days; postprogram, 3.3 days; p < 0.005).

Conclusions

A simple, low-cost, outpatient PRP was able to improve health outcome for patients with COPD. Hospital utilization and health cost were reduced as well.

Section snippets

Materials and Methods

Patients were referred to the program by specialists, general physicians, or general practitioners. The program was conducted by a physiotherapist, and patients attended twice a week for 8 weeks of the PRP. Patients with COPD and FEV1 < 60% predicted or limitation of exertion by dyspnea were enrolled into the program. Exclusion criteria were severe cardiovascular disease or other comorbidities that limited exercise. The program consisted of increasing exercise endurance training, as well as

Patient Demographics

Consecutive patients with COPD who attended the first 18 months after commencement of the program were analyzed. During that time, 42 patients were enrolled. All patients had COPD, and one patient had coexisting asbestosis. Six patients dropped out, and data from the remaining 36 patients who completed the program were analyzed. Demographic characteristics are shown in Table 1.

Lung Functions, QOL, and Exercise Capacity

At the end of the program, there were no significant changes in lung functions. However, 6MWD increased significantly

Discussion

Multidisciplinary PRPs have been shown to benefit patients with COPD. Our results showed that a simple PRP was able to improve exercise capacity as well as health outcome and QOL in patients with COPD. Although our study was not a randomized control trial, the results were consistent with previous randomized controlled trials using more comprehensive multidisciplinary PRPs. In addition, episodes of hospitalization and LOS were reduced for 12 months after completion of program.

Improvement in

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