Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25628
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dc.contributor.authorWageck, Bruna-
dc.contributor.authorCox, Narelle S-
dc.contributor.authorMcDonald, Christine F-
dc.contributor.authorBurge, Angela T-
dc.contributor.authorMahal, Ajay-
dc.contributor.authorHill, Catherine J-
dc.contributor.authorLee, Annemarie L-
dc.contributor.authorMoore, Rosemary P-
dc.contributor.authorNicolson, Caroline-
dc.contributor.authorO'Halloran, Paul-
dc.contributor.authorLahham, Aroub-
dc.contributor.authorGillies, Rebecca-
dc.contributor.authorHolland, Anne E-
dc.date2020-12-31-
dc.date.accessioned2021-01-13T03:00:21Z-
dc.date.available2021-01-13T03:00:21Z-
dc.date.issued2020-12-31-
dc.identifier.citationInternational Journal of Chronic Obstructive Pulmonary Disease 2020; 15: 3423-3431en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/25628-
dc.description.abstractPulmonary 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.en
dc.language.isoeng
dc.subjectCOPDen
dc.subjectexacerbationsen
dc.subjectlong term maintenanceen
dc.subjectpredictorsen
dc.subjectpulmonary rehabilitationen
dc.titleThe Impact of COPD Exacerbations in the Year Following Pulmonary Rehabilitation: Secondary Analysis of a Randomised Controlled Trial.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternational Journal of Chronic Obstructive Pulmonary Diseaseen
dc.identifier.affiliationThe Nossal Institute of Global Health, The University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationRespiratory and Sleep Medicineen
dc.identifier.affiliationDepartment of Medicine, The University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Physiotherapy, Alfred Health, Melbourne, Australiaen
dc.identifier.affiliationPhysiotherapyen
dc.identifier.affiliationDepartment of Pulmonary Hypertension, Alfred Health, Melbourne, Australiaen
dc.identifier.affiliationPhysiotherapy Department, Monash University, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Public Health, La Trobe University, Melbourne, Australiaen
dc.identifier.affiliationLa Trobe University, Melbourne, Australiaen
dc.identifier.affiliationMonash University, Melbourne, Australiaen
dc.identifier.affiliationInstitute for Breathing and Sleepen
dc.identifier.doi10.2147/COPD.S271094en
dc.type.contentTexten
dc.identifier.orcid0000-0001-8956-8767en
dc.identifier.orcid0000-0002-6977-1028en
dc.identifier.orcid0000-0001-5455-6467en
dc.identifier.orcid0000-0002-7246-3261en
dc.identifier.pubmedid33408472
local.name.researcherBurge, Angela T
item.languageiso639-1en-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptRespiratory and Sleep Medicine-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptPhysiotherapy-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptPhysiotherapy-
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