Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2014 Oct 3:9:1059-67.
doi: 10.2147/COPD.S69574. eCollection 2014.

Reduction of exacerbation frequency in patients with COPD after participation in a comprehensive pulmonary rehabilitation program

D van Ranst  1 , W A Stoop  1 , J W Meijer  1 , H J Otten  1 , I G van de Port  1
Affiliations
Observational Study

Reduction of exacerbation frequency in patients with COPD after participation in a comprehensive pulmonary rehabilitation program

D van Ranst et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Pulmonary rehabilitation (PR) is an important treatment option for chronic obstructive pulmonary disease (COPD) patients and might contribute to a reduction in exacerbation and exacerbation-related hospitalization rate.

Methods: In this prospective study, all COPD patients that completed a comprehensive pulmonary rehabilitation program (PRP) between June 2006 and December 2012 were included. Self-reported exacerbation and hospitalization frequency 1 year before PR was retrospectively recorded. During the year following PR, exacerbation and hospitalization frequency was recorded with questionnaires.

Results: For 343 patients, complete information on exacerbation and hospitalization rate was obtained. The mean number of exacerbations decreased significantly after participating in a PRP by 1.37 exacerbations/year (95% confidence interval 1.029 to 1.717) from 4.56±3.26 exacerbations in the year preceding PR to 3.18±2.53 in the year following PR (P<0.0005). The number of hospitalizations due to exacerbations decreased significantly by 0.68 hospitalizations/year (95% confidence interval 0.467 to 0.903) from 1.48±1.84 in the year preceding PR to 0.80±1.31 hospitalizations/year in the year following PR (P<0.0005). The proportion of patients with a frequent exacerbation type (more than two exacerbations/year) was reduced by 24%. Multivariate regression analysis to explore determinants that might predict reduction in exacerbation frequency or change in exacerbation pattern did not reveal clinically useful predictors, although patients with more exacerbations before PR had the highest potential for reduction.

Conclusion: In a large population of severely impaired COPD patients with high exacerbation rates, a significant reduction in exacerbation and hospitalization frequency was observed after participation in a comprehensive PRP.

Keywords: disease management; health care utilization; health status; hospitalization; self-management.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean number of exacerbations (total), hospitalizations, and exacerbations out of hospital 1 year before and 1 year after PR. Note: *P<0.0005. Abbreviation: PR, pulmonary rehabilitation.
Figure 2
Figure 2
Frequent and infrequent exacerbations 1 year before and 1 year after PR. Notes: A McNemar test showed that the difference in the proportion of frequent and infrequent exacerbations before and after PR was statistically significant (X2[1]=21.008; P<0.0005). Abbreviation: PR, pulmonary rehabilitation.
See this image and copyright information in PMC

References

    1. Lacasse Y, Goldstein R, Lasserson TJ, Martin S. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006;(4):CD003793. - PubMed
    1. van Ranst D, Otten H, Meijer JW, van ‘t Hul AJ. Outcome of pulmonary rehabilitation in COPD patients with severely impaired health status. Int J Chron Obstruct Pulmon Dis. 2011;6:647–657. - PMC - PubMed
    1. Ochmann U, Jörres RA, Nowak D. Long-term efficacy of pulmonary rehabilitation: a state-of-the-art review. J Cardiopulm Rehabil Prev. 2012;32(3):117–126. - PubMed
    1. Bourbeau J. Activities of life: the COPD patient. COPD. 2009;6(3):192–200. - PubMed
    1. Marchetti N, Criner GJ, Albert RK. Preventing acute exacerbations and hospital admissions in COPD. Chest. 2013;143(5):1444–1454. - PubMed

Publication types

MeSH terms