Pulmonary Rehabilitation: Pulmonary Rehabilitation |

Effectiveness of Temporary Positive Expiratory Pressure (T-PEP) at Home and at Hospital in Patients With Severe COPD FREE TO VIEW

Ines Piroddi, MD; Antonello Nicolini, MD; Giovanni Veronesi, MD
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Respiratory Diseases Unit, Sestri Levante, Italy

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A490. doi:10.1016/j.chest.2016.02.511
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SESSION TITLE: Pulmonary Rehabilitation

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of obstructive pulmonary diseases such as chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD

METHODS: 142 patients with severe COPD (FEV1 < 50%) were enrolled;120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group). Number of exacerbations after 1 month,3 months and 6 months was the primary outcome. Secondary outcomes were changes in respiratory function parameters (FVC, FEV1, TLC, RV), arterial blood gases analysis, dyspnea and quality of life scales (Modified Medical Research Council (MMRC), Breathlessness, Cough and Sputum scale (BCSS) and COPD Assessment Test (CAT). The time of daily use of the T-PEP was registered as well as its acceptance using a Likert scale

RESULTS: 99 patients completed the study. Both the groups who used T-PEP showed a statistical reduction in exacerbations after 3 months (p<0.03) and 6 months (p<0.003). Some respiratory functional parameters improved in the two groups treated with T-PEP (FVC, FEV1, RV) (p<0.001) and dyspnea and quality of life scales (MMRC, BCSS, CAT) (p<0.001). The daily using was similar in the two T-PEP groups. Patients treated at home showed a greater acceptance than those treated at hospital (Likert scale 5.2 vs 5.7) (p<0.01)

CONCLUSIONS: Treatment with T-PEP demonstrated efficacy to reduce exacerbations in patients with severe COPD. T-PEP improves functional respiratory parameters and improves dyspnea and quality of life scales. No adherence difference in hospital and home treatment was found. Patients preferred home treatment

CLINICAL IMPLICATIONS: Adding an airway clearence tool to medical treatment can reduce exacerbations, improve functional lung parameters, quality of life scores in patients with severe COPD both at clinic and at home.

DISCLOSURE: The following authors have nothing to disclose: Ines Piroddi, Antonello Nicolini, Giovanni Veronesi

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