Managing Chronic Obstructive Pulmonary Disease in the Community
- 1 November 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Cardiopulmonary Rehabilitation
- Vol. 25 (6), 378-385
- https://doi.org/10.1097/00008483-200511000-00012
Abstract
Pulmonary rehabilitation is essential for managing chronic obstructive pulmonary disease (COPD). Housebound COPD patients are frequently excluded from this treatment because they are unable to access outpatient pulmonary rehabilitation programs because of the severity of their disease. This randomized controlled trial assesses the effects of a 12-week home-based pulmonary rehabilitation program for 60 housebound COPD patients older than 60 years. Intervention patients received an individually tailored supervised walking and arm exercise program as well as individual multidisciplinary education sessions on COPD and its management. Outcomes were assessed using the 6-minute walk test, St George's respiratory questionnaire, and Borg score of perceived breathlessness. Healthcare utilization was assessed using hospital admission rates with exacerbation of COPD and average length of stay at readmission. Complete data for 23 patients in each group were available for analysis. There was no significant difference between groups on baseline measures. Compared with the control group, intervention patients demonstrated a significant improvement in 6-minute walk test (P = .023), Borg score of perceived breathlessness (P = .024), St George's respiratory questionnaire total score (P = .020), and impact subscore (P = .024). At 6 months, the intervention group had a significantly shorter average length of stay at readmission to hospital with exacerbation (P = .035). A 12-week home-based pulmonary rehabilitation is effective in improving exercise tolerance, perception of breathlessness, and quality of life for housebound COPD patients. To manage COPD in the community more effectively, health services should focus on expanding home-based pulmonary rehabilitation.Keywords
This publication has 21 references indexed in Scilit:
- Factors Associated with Increased Risk of Exacerbation and Hospital Admission in a Cohort of Ambulatory COPD Patients: A Multiple Logistic Regression AnalysisRespiration, 2000
- Disease Management of COPD With Pulmonary RehabilitationChest, 1997
- BTS Guidelines for the Management of Chronic Obstructive Pulmonary DiseaseThorax, 1997
- Pulmonary RehabilitationChest, 1997
- Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease StudyThe Lancet, 1997
- Feasibility and Effects of a Home-Care Rehabilitation Program in Patients With Chronic Obstructive Pulmonary DiseaseJournal of Cardiopulmonary Rehabilitation, 1996
- A Comparison Between an Outpatient Hospital-Based Pulmonary Rehabilitation Program and a Home-Care Pulmonary Rehabilitation Program in Patients With COPDChest, 1996
- Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease.Thorax, 1995
- Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at homeEuropean Respiratory Journal, 1994
- Physical rehabilitation for the chronic bronchitic: results of a controlled trial of exercises in the home.Thorax, 1977