PURPOSE: Acute exacerbations of Chronic obstructive pulmonary disease(AECOPD) incur heavy utilization of healthcare resources for patients who require hospitalization. We evaluated if an early out-patient pulmonary rehabilitation programme(PRP) after hospitalization for AECOPD could reduce acute healthcare utilization over a period of 1 year.
METHODS: 60 patients admitted with AECOPD were randomized to either PRP or usual care(UC). The PRP group received 8 weeks of out-patient rehabilitation program 2-3 weeks after discharge from hospital. Lung function, 6 minute walk test(6MWT) and dyspnoea score were assessed at baseline, 3, 6, 9, and 12 months, while St George’ s respiratory questionnaire[SGRQ] and cardiopulmonary exercise test were assessed at baseline, 3, 6, and 12 months.
RESULTS: The PRP and UC group demonstrated a 53.3% and 43.3% risk of readmissions at 12 months (incident risk ratio 0.97[95%CI 0.57-1.60], p=0.90). The mean re-admission rates were 1.00±1.20 and 1.03±1.87 (p=0.47) for the PRP versus UC group respectively. The rates of AECOPD and emergency department visits were similar between the 2 groups. The SGRQ total score was lower in the PRP group (40.15±19.10 vs 46.91±18.21, p=0.01 and 42.3±20.06 vs 51.44±18.98 p=0.01 at 3 and 6 months respectively). There were no statistically significant differences in the FEV1 % predicted, dyspnoea score, 6MWT and maximal oxygen consumption by exercise test between PRP and UC at different time points.
CONCLUSION: An early rehabilitation programme following AECOPD led to improvement in quality of life among the subjects up to 6 months, but did not reduce health care utilization at 1 year.
CLINICAL IMPLICATIONS: This prospective randomized study has shown that an 8-week early PRP following AECOPD resulted in better health status of the subjects up to 6 months without reduction in healthcare utilization at 1 year.
DISCLOSURE: Fanny Ko, No Financial Disclosure Information; No Product/Research Disclosure Information