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
. 2018 Jan 11:12:97-104.
doi: 10.2147/PPA.S150679. eCollection 2018.

A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Yi Li  1   2 , Jing Feng  3   4 , Yuechuan Li  2 , Wei Jia  2 , Hongyu Qian  2
Affiliations

A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Yi Li et al. Patient Prefer Adherence. .

Abstract

Background: The benefit of pulmonary rehabilitation (PR) for patients with COPD diminishes over time. We investigated a new strategy involving home-visit and phone contact and compared this to usual care in maintenance of PR benefits.

Methods: A total of 172 stable COPD patients receiving 8-week PR program were recruited for this prospective study. Patients were allocated into usual care group (UC) and PR maintenance group (PRMG) randomly. Patients in PRMG participated in maintenance strategy at home under supervision through home-visit and phone contact. The 6-minute walking test (6MWT), COPD assessment test (CAT), and modified Medical Research Council scale (mMRC) scores were evaluated every 3 months.

Results: Of the total, 151 patients completed 8-week PR program with satisfactory PR results (p<0.001), and 104 patients finished the follow-up. The clinical improvements in 6MWT, CAT, and mMRC scores were maintained (p<0.001) in PRMG. In comparison, the benefit of PR diminished gradually in UC. The differences in 6MWT, CAT, and mMRC scores between groups were observed 6, 9, and 6 months after PR, respectively (p<0.05). Total frequency of exacerbations in PRMG was lower than UC (p=0.021).

Conclusion: Maintenance strategy involving home-visit and phone contact is superior to usual care to preserve PR benefits, and reduces the acute COPD exacerbation rate.

Keywords: 6-minute walking test; COPD; COPD assessment test; maintenance; pulmonary rehabilitation.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of participants throughout the study. Abbreviation: PR, pulmonary rehabilitation.
Figure 2
Figure 2
The patterns of 6MWT, mMRC, and COPD assessment during 1-year follow-up between groups. Notes: (A) The patterns of 6MWT during 1-year follow-up between groups. (B) The patterns of COPD assessment during 1-year follow-up between groups. (C) The patterns of mMRC assessment during 1-year follow-up between groups. Data shown are mean values with error bars representing SE. Hollow circles express control groups, while solid circles express pulmonary rehabilitation maintenance group. 0 month expresses the time point when patients finished the pulmonary rehabilitation program. *Significant differences between groups at different time points (p<0.05). Abbreviations: 6MWT, 6-minute walking test; mMRC, modified Medical Research Council scale; SE, standard error; CAT, COPD assessment test; PR, pulmonary rehabilitation.
See this image and copyright information in PMC

References

    1. Vogelmeier CF, Criner GJ, Martínez FJ, et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report: GOLD executive summary. Eur Respir J. 2017;49(3) pii 1700214. - PubMed
    1. Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest. 2007;131(5 Suppl):4S–42S. - PubMed
    1. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13–e64. - PubMed
    1. Rochester CL, Vogiatzis I, Holland AE, et al. ATS/ERS Task Force on Policy in Pulmonary Rehabilitation An official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med. 2015;192(11):1373–1386. - PubMed
    1. Solanes I, Güell R, Casan P, et al. Duration of pulmonary rehabilitation to achieve a plateau in quality of life and walk test in COPD. Respir Med. 2009;103(5):722–728. - PubMed