Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

Mesquita, Rafael; Vanfleteren, Lowie E.G.W.; Franssen, Frits M.E.; Sarv, Janeli; Taib, Ziad; Groenen, Miriam T.J.; Gaffron, Swetlana; Bruijnzeel, P. L. B.; Pitta, Fábio; Wouters, Emiel F.M.; Spruit, Martijn A.

doi:10.1183/09031936.00026215

Cited by 41 publications

(35 citation statements)

References 16 publications

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“…These findings suggest that self-reported comorbidities generally do not influence the multidimensional response to PR. Recently, MESQUITA et al [44] also showed that changes in exercise performance and health status were not affected by comorbidities that were based on objective measurements.…”

Section: Response Predictionmentioning

confidence: 99%

Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

et al. 2015

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The aim of the present study was to profile a multidimensional response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD).Dyspnoea, exercise performance, health status, mood status and problematic activities of daily life were assessed before and after a 40-session pulmonary rehabilitation programme in 2068 patients with COPD (mean forced expiratory volume in 1 s of 49% predicted). Patients were ordered by their overall similarity concerning their multidimensional response profile, which comprises the overall response on MRC dyspnoea grade, 6MWD, cycle endurance time, Canadian Occupational Performance Measure performance and satisfaction scores, Hospital Anxiety and Depression Scale anxiety and depression, and St George's Respiratory Questionnaire total score, using a novel non-parametric regression technique.Patients were clustered into four groups with distinct multidimensional response profiles: n=378 (18.3%; "very good responder"), n=742 (35.9%; "good responder"), n=731 (35.4%; "moderate responder"), and n=217 (10.5%; "poor responder"). Patients in the "very good responder" cluster had higher symptoms of dyspnoea, number of hospitalisations <12 months, worse exercise performance, worse performance and satisfaction scores for problematic activities of daily life, more symptoms of anxiety and depression, worse health status, and a higher proportion of patients following an inpatient PR programme compared to the other three clusters.A multidimensional response outcome needs to be considered to study the efficacy of pulmonary rehabilitation services in patients with COPD, as responses to regular outcomes are differential within patients with COPD. @ERSpublications Efficacy of pulmonary rehabilitation in patients with COPD needs to be assessed using a multidimensional response http://ow.ly/RsfYK

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Section: Response Predictionmentioning

confidence: 99%

Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

et al. 2015

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“…The latter might not be surprising because walking is a weight-bearing exercise and patients belonging to the metabolic cluster were more likely to be obese. 13 Overall, we can conclude that comorbid CVD is not a reason to withheld patients from rehab programs.…”

Section: Influence Of Cvd On Pr Outcomesmentioning

confidence: 99%

“…12 More recently, Mesquita et al evaluated the objectively identified comorbidities and clusters of comorbidities in the CIROCO study against conventional PR outcomes. 13 Interestingly, no individual cardiovascular or other comorbidity influenced the likelihood of achieving clinically important benefit on exercise capacity (6MWD and constant work cycling test) and quality of life (SGRQ). More interesting was the comparison of different comorbidity clusters in terms of rehabilitation outcomes, as these multimorbidity groups reflect the clinical reality.…”

Section: Influence Of Cvd On Pr Outcomesmentioning

confidence: 99%

Cardiovascular risk, chronic obstructive pulmonary disease and pulmonary rehabilitation

2016

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Patients with chronic obstructive pulmonary disease (COPD) who participate in pulmonary rehabilitation (PR) often have concomitant cardiovascular disease (CVD), which is a frequently undiagnosed and undertreated comorbidity. CVD contributes to the burden of the disease and is associated with an increased risk for hospitalizations and mortality. Optimizing the diagnosis and management of cardiovascular risk and disease should be considered as part of the holistic approach of PR. In addition, we need to consider similarities and differences in cardiac and PR programs, in order to improve personalized care in patients with both diseases. The current review addresses the burden of CVD in COPD patients who participate in PR, how CVD and its risk factors affect PR and should be managed during PR, and extends on what we can learn of the organization of cardiac rehabilitation programs.

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“…Moreover, these findings emphasise that key performance measures to evaluate effectiveness of PR programmes have to be selected within multiple domains, also related to what a patient perceives in his/her daily life [11]. In addition, although Copyright clinical complexity associated with number and severity of comorbidities is not a contraindication for PR [12], we cannot exclude that this complexity may lead to interference with outcomes [13].…”

mentioning

confidence: 92%

Response to pulmonary rehabilitation: toward personalised programmes?

Ambrosino¹,

Clini

2015

Eur Respir J

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Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

Cited by 41 publications

References 16 publications

Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

Differential response to pulmonary rehabilitation in COPD: multidimensional profiling

Cardiovascular risk, chronic obstructive pulmonary disease and pulmonary rehabilitation

Response to pulmonary rehabilitation: toward personalised programmes?

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