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. 2025 Jan 7;15(1):e092096.
doi: 10.1136/bmjopen-2024-092096.

Is longer really better? Results of a retrospective real-life cohort study evaluating the benefit of adding a weekly educational session to a traditional 8-week home-based pulmonary rehabilitation programme in people with COPD

Sarah Gephine  1   2 , Olivier Le Rouzic  3 , Sophie Peres  4 , Cécile Chenivesse  3 , Jean-Marie Grosbois  5
Affiliations

Is longer really better? Results of a retrospective real-life cohort study evaluating the benefit of adding a weekly educational session to a traditional 8-week home-based pulmonary rehabilitation programme in people with COPD

Sarah Gephine et al. BMJ Open. .

Abstract

Objectives: To evaluate the short-term and long-term benefits of adding a weekly educational session to a traditional 8-week home-based pulmonary rehabilitation (PR) programme in people with chronic obstructive pulmonary disease (COPD). Primary hypothesis was that 8 home-based supervised sessions will be equivalent to 16 home-based supervised sessions at both short- and long-term after PR.

Design: Retrospective cohort study conducted on prospectively collected real-life data, from January 2010 to December 2021.

Setting: FormAction Santé, Pérenchies France.

Participants: Eligible individuals were aged >18 years with a diagnosis of COPD and referred to the home-based PR programme by their respiratory physician. Participants were retrospectively divided into two groups (Gr 1, 8 PR sessions, n=759, and Gr 2, 8 PR sessions+8 educational sessions, n=262).

Intervention: All participants received an 8-week personalised home PR programme. A subgroup of participants received one additional supervised home session per week, including education and motivational support for daily physical activities and walking.

Outcomes: Health-related quality of life, dyspnoea, anxiety and depressive symptoms, fatigue and exercise tolerance were assessed at baseline (M0), at the end of PR (M2), and 14 months (M14) after M0.

Results: Baseline characteristics and assessments were similar between groups with an exception for long-term oxygen therapy (Gr1: 69.8% vs Gr2 53.0%, p<0.001) and noninvasive ventilation (Gr1: 38.6% vs Gr2: 29.8%, p=0.015). At M2 and M14, all the assessments were improved in both groups (p<0.01). At M2, the improvement in health status and exercise tolerance was higher in Gr 2 compared with Gr 1 (p<0.05). From M0 to M14, 90 (11.9%) participants and 29 (11.1%) participants died in Gr 1 and Gr 2, respectively (p=0.794).

Conclusion: People with COPD benefited, at short and long terms, from both 8 or 16 supervised home-based PR sessions. Once-weekly home-based supervised sessions during 8 weeks, combined with unsupervised physical training sessions and self-management plan for the other health behaviours, might be the best compromise between patients, health professionals and policy makers.

Keywords: Health Education; Pulmonary Disease, Chronic Obstructive; REHABILITATION MEDICINE.

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Conflict of interest statement

Competing interests: OLR reports personal fees and non-financial support unrelated to the submitted work from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline, MSD France, Vertex and Vitalaire. OLR is principal investigator in studies for Vertex and CSL Behring. SP is employed by Santélys company. CC reports personal fees and non-financial support unrelated to the submitted work from ALK-Abello, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKlein, MEDA Pharma, Medexact, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi, Santélys, and TEVA. JMG reports personal fees and non-financial support unrelated to the submitted work from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKlein.

Figures

Figure 1
Figure 1. Flowchart of study participants.
Figure 2
Figure 2. Box plot showing delta improvements of the 6-min stepper test (6MST) at the end of pulmonary rehabilitation (A) and the end of the 1-year follow-up (B) in people who received 8 sessions (GR 1, black box plot) and people who received 16 sessions (Gr 2, grey box plot). Values are expressed in median and range. The minimal clinically important difference of the 6MST is considered to be a change of 40 strokes.
See this image and copyright information in PMC

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