Please use this identifier to cite or link to this item:
https://ahro.austin.org.au/austinjspui/handle/1/25628
Title: | The Impact of COPD Exacerbations in the Year Following Pulmonary Rehabilitation: Secondary Analysis of a Randomised Controlled Trial. | Austin Authors: | Wageck, Bruna;Cox, Narelle S ;McDonald, Christine F ;Burge, Angela T ;Mahal, Ajay;Hill, Catherine J ;Lee, Annemarie L;Moore, Rosemary P ;Nicolson, Caroline;O'Halloran, Paul;Lahham, Aroub;Gillies, Rebecca;Holland, Anne E | Affiliation: | The Nossal Institute of Global Health, The University of Melbourne, Melbourne, Australia Respiratory and Sleep Medicine Department of Medicine, The University of Melbourne, Melbourne, Australia Department of Physiotherapy, Alfred Health, Melbourne, Australia Physiotherapy Department of Pulmonary Hypertension, Alfred Health, Melbourne, Australia Physiotherapy Department, Monash University, Melbourne, Australia Department of Public Health, La Trobe University, Melbourne, Australia La Trobe University, Melbourne, Australia Monash University, Melbourne, Australia Institute for Breathing and Sleep |
Issue Date: | 31-Dec-2020 | Date: | 2020-12-31 | Publication information: | International Journal of Chronic Obstructive Pulmonary Disease 2020; 15: 3423-3431 | Abstract: | Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease (COPD), but its benefits are poorly maintained. The aim of this study was to evaluate the impact of COPD exacerbations in the year following pulmonary rehabilitation on outcomes at 12 months. This was a secondary analysis from a trial of home versus hospital-based rehabilitation in COPD, with 12 months of follow-up. Moderate and severe exacerbations were identified using administrative data (prescriptions) and hospital records (admissions) respectively. The impact of exacerbations at 12 months following pulmonary rehabilitation was evaluated for quality of life (Chronic Respiratory Questionnaire, CRQ), dyspnea (modified Medical Research Council, mMRC), exercise capacity (6-minute walk distance, 6MWD) and objectively measured physical activity (moderate-to-vigorous physical activity, MVPA). A total of 166 participants were included, with mean age (SD) 69 (9) years and forced expiratory volume in one second (FEV1) 49 (19)% predicted. Moderate exacerbations occurred in 68% and severe exacerbations in 34% of participants. Experiencing a severe exacerbation was an independent predictor of worse 12-month outcomes for CRQ (total, fatigue and emotional function domains), mMRC, 6MWD and MVPA (all p<0.05). Participants who completed pulmonary rehabilitation were less likely to have a severe exacerbation (29% vs 48%, p=0.02). Severe exacerbations were more likely in those with worse baseline CRQ total (odds ratio 0.97, 95% CI 0.95 to 0.99) and FEV1%predicted (0.98, 95% CI 0.96 to 0.99). Severe exacerbations occur frequently following pulmonary rehabilitation and predict worse 12-month outcomes. Strategies to maintain the benefits of pulmonary rehabilitation should address exacerbation prevention and management. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/25628 | DOI: | 10.2147/COPD.S271094 | ORCID: | 0000-0001-8956-8767 0000-0002-6977-1028 0000-0001-5455-6467 0000-0002-7246-3261 |
Journal: | International Journal of Chronic Obstructive Pulmonary Disease | PubMed URL: | 33408472 | Type: | Journal Article | Subjects: | COPD exacerbations long term maintenance predictors pulmonary rehabilitation |
Appears in Collections: | Journal articles |
Show full item record
Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.