Impact of exacerbations on adherence and outcomes of pulmonary rehabilitation in patients with <scp>COPD</scp>

Braeken, Dionne C.W.; Spruit, Martijn A.; Houben-Wilke, Sarah; Smid, Dionne E.; Rohde, Gernot; Wouters, Emiel F.M.; Franssen, Frits M.E.

doi:10.1111/resp.12987

Cited by 15 publications

(25 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In general, patients had moderate to severe airflow obstruction and were highly symptomatic; 94% of the patients were classified in GOLD B or D. Patients who did not complete PR were more often current smokers, had a significantly worse diffusion capacity, a shorter 6MWD and reported more dyspnea compared to patients who completed PR (Table 1 ). Reasons for dropout have been described before [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores

Houben-Wilke

Janssen

Franssen

et al. 2018

Health Qual Life Outcomes

Self Cite

View full text Add to dashboard Cite

BackgroundThe COPD Assessment Test (CAT) contains eight items (cough, phlegm, chest tightness, breathlessness, limited activities, confidence leaving home, sleeplessness and energy). The current study aimed 1) to better understand the impact of the respiratory and non-respiratory CAT item scores on the CAT total score; and 2) to determine the impact of pulmonary rehabilitation (PR) on CAT items and CAT total score.MethodsCAT total score of ≥10 or ≥ 18 points was used to classify patients as highly symptomatic, a decrease of 2 points was considered as clinically relevant improvement. ‘Cough’, ‘phlegm’, ‘chest tightness’, ‘breathlessness’ were defined as respiratory items; ≥3 points on each item was defined as highly symptomatic.ResultsIn total, 497 clinically stable patients (55% male, age 64.0 (57.5–71.0) years, FEV1 46.0 (32.0–63.0)% predicted, CAT total score 22.0 (17.5–26.0) points) were included. 95% had CAT score ≥ 10 points and 75% ≥18 points. Respectively, 45% and 54% of subjects scored high on 3 or 4 of the respiratory CAT items. Following PR, 220 patients (57.7%) reported an improved health status as assessed by CAT total score (− 3.0 (− 7.0–1.0) points). Change in CAT item scores ranged from 0.0 (− 1.0–0.0) to − 1.0 (− 2.0–0.0) points) with best improvements in ‘energy’ (− 1.0 (− 2.0–0.0)points).ConclusionsA substantial number of patients classified as highly symptomatic did not report a high level of respiratory symptoms, indicating that non-respiratory symptoms impact on disease classification and treatment algorithm. The impact of PR on CAT item scores varied by individual item.Trial registrationNetherlands National Trial Register (NTR3416). Registered 2 May 2012.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-1034-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores

Houben-Wilke

Janssen

Franssen

et al. 2018

Health Qual Life Outcomes

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similar high scores were seen in other COPD cohorts worldwide, suggesting a comparable burden due to the disease in subjects with COPD. [15][16][17][18][19][20][21] However, we herein present the first real-life data of stable COPD patients in an outpatient setting in Austria, documenting the impact of disease on their daily life using the well-established SGRQ-C.…”

Section: Discussionmentioning

confidence: 99%

<p>Quality of Life and Limitations in Daily Life of Stable COPD Outpatients in a Real-World Setting in Austria – Results from the CLARA Project</p>

Hörner¹,

Burghuber²,

Hartl³

et al. 2020

COPD

View full text Add to dashboard Cite

Background COPD patients suffer from respiratory symptoms and limitations in daily life. We aimed to characterize the impact of disease on overall health, daily life, and perceived well-being in COPD outpatients. Methods We conducted a national, cross-sectional study among pulmonologists and general practitioners (GPs). The St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C) was used. Inclusion criteria were a physician’s diagnosis of COPD and age ≥40 years. Subjects with a history of lung surgery, lung cancer or COPD exacerbation within the last four weeks were excluded. Results Sixty-seven pulmonologists and 6 GPs enrolled 1175 COPD patients. Two hundred forty-eight of those did not fulfill GOLD criteria for COPD (FEV 1 /FVC <0.7) and 77 were excluded due to missing data. Finally, 850 patients (62.8% men; mean age 66.2 ± 0.3 (SE) years; mean FEV 1 %pred. 51.5 ± 0.6 (SE)) were analyzed. Last year, 55.4% reported at least one exacerbation, and 12.7% were hospitalized for COPD exacerbation. Mean SGRQ-C total score was 43.1 ± 0.83 (SE) and mean component scores for symptoms, activity and impacts were 55.6, 55.4 and 30.5, respectively. Half of the patients (50.3%) reported not being able to do any sports and 78.7% stated that their respiratory symptoms did not allow them doing anything they would like to do. In patients with less severe COPD (FEV 1 pred ≥50% and non-frequent exacerbations), global health status was overrated, ie, estimated as better by the physician than by the patient, while it was underrated in more severe COPD. Conclusion In Austria, the burden of disease in COPD outpatients tends to be underestimated in patients with milder airway obstruction and less exacerbations and overestimated in patients with more severe airway obstruction and frequent exacerbations. Our finding suggests that validated assessment of global health status might decrease these differences of perception.

show abstract

“…O estudo de Braeken et al 20 que objetivava avaliar o impacto de exacerbações leves, moderadas e graves no abandono e nos resultados da RP, identificou por meio da avaliação de 466 pacientes que a ocorrência de exacerbações leves e moderadas não afetam a taxa de conclusão do programa, entretanto as exacerbações graves estão associadas a aumento do abandono. Foi observado também que os pacientes que concluem a reabilitação, mesmo após a ocorrência de uma exacerbação grave, respondem positivamente ao tratamento.…”

Section: Discussionunclassified

Barreiras à adesão ao programa de reabilitação pulmonar de pacientes com doença pulmonar obstrutiva crônica

Fonte¹,

Gomes²,

Cruz³

et al. 2020

ASSOBRAFIR Ciênc

View full text Add to dashboard Cite

Artigo de RevisãoEste é um artigo publicado em acesso aberto (Open Access) e distribuído sob a licença Creative Commons Attribution NonComercial ShareAlike License, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado e de forma que não indique endosso ao trabalho feito. A ResumoIntrodução: A reabilitação pulmonar é de suma importância para pacientes com DPOC. Entretanto, a adesão ao tratamento é baixa. Compreender os motivos da baixa adesão é imprescindível para o sucesso da terapia. Objetivo: Identificar as barreiras ao comparecimento e adesão de pacientes com DPOC à reabilitação pulmonar. Métodos: Realizou-se uma revisão integrativa da literatura. A localização e seleção dos estudos foi realizada por meio de pesquisa nas bases de dados eletrônicas Medline (acessada pelo PubMed) e Scientific Electronic Library Online (SciELO). A estratégia utilizada foi o cruzamento dos descritores "COPD", "Treatment Adherence and Compliance" e "Rehabilitation". Foram incluídos artigos publicados a partir de 2009 até maio de 2019, escritos nos idiomas inglês, português e espanhol, elegendo como população alvo indivíduos com DPOC que realizaram reabilitação pulmonar e tendo como desfecho a adesão ao tratamento. Resultados: A busca resultou em um achado de 566 artigos nas bases de dados MEDLINE, SCIELO e LILACS, que destes 16 foram incluídos no estudo. Conclusão: As principais barreiras de adesão a reabilitação pulmonar foram tabagismo atual, falta de informação acerca da patologia e da efetividade de tratamento, presença de comorbidades, percepção negativa do estado de saúde, dificuldades de mobilidade e transporte e a falta de apoio social.

show abstract

Impact of exacerbations on adherence and outcomes of pulmonary rehabilitation in patients with COPD

Abstract: Mild-to-moderate AEs do not affect dropout or response of PR, although severe AEs are associated with dropout. AEs should not lead to discontinuation of PR, as response is in general not affected.

Cited by 15 publications

References 28 publications

Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores

Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores

<p>Quality of Life and Limitations in Daily Life of Stable COPD Outpatients in a Real-World Setting in Austria – Results from the CLARA Project</p>

Barreiras à adesão ao programa de reabilitação pulmonar de pacientes com doença pulmonar obstrutiva crônica

Contact Info

Product

Resources

About