Response to pulmonary rehabilitation: toward personalised programmes?

Ambrosino, Nicolino; Clini, Enrico

doi:10.1183/13993003.01125-2015

Cited by 30 publications

(28 citation statements)

References 13 publications

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“…Stemming from our experience and from literature, we think that pulmonary rehabilitation treatment, which integrates an interdisciplinary approach, a pharmacological/nonpharmacological management and a tailored intervention, could optimize the therapeutic approach in COPD patients without neglecting their clinical, relational and psychosocial needs 4,8,9,38,45,47,48…”

Section: Resultsmentioning

confidence: 94%

COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

Pierobon¹,

Bottelli²,

Ranzini³

et al. 2017

COPD

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In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III–IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions (P=0.0004, odds ratio =0.796, 95% CI =0.701, 0.903; P=0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and P=0.05, odds ratio =2.361, 95% CI =0.995, 5.627 respectively). In COPD patients, focusing on pharmacological and nonpharmacological adherence enhance the possibility of tailored pulmonary rehabilitation programs.

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Section: Resultsmentioning

confidence: 94%

COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

Pierobon¹,

Bottelli²,

Ranzini³

et al. 2017

COPD

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“…Moreover, given the multifaceted aspects of adherence and such a widespread presence of MCI or cognitive impairment in the COPD population, the rehabilitative project should be personalized and tailored to individual needs. It is clear that there are many factors to be considered and managed, thus an interdisciplinary approach should be always implemented to cope with this complex issue, in particular in inpatient and outpatient rehabilitation settings, in order to favor a more and more individualized and personalized treatment (Ambrosino and Clini, 2015).…”

Section: Resultsmentioning

confidence: 99%

From Mild Cognitive Impairment (MCI) to Dementia in Chronic Obstructive Pulmonary Disease. Implications for Clinical Practice and Disease Management: A Mini-Review

et al. 2020

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Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease characterized by partially irreversible chronic airflow limitation. Current literature highlights that COPD patients also have an increased risk to develop Mild Cognitive Impairment (MCI) and dementia. Chronic patients with cognitive impairment experience a worsening of health-related quality of life, mainly because it could affect treatment self-management, medication adherence and personal independence. Moreover, they also report high levels of anxiety and depression, which are associated with disease severity, poor quality of life, poor adherence to rehabilitation programs and difficulties in selfmanagement. In current literature, there is a lack of studies describing simultaneously the associations between cognitive impairment, dysfunctional psychosocial factors, self-management abilities and their impact on pharmacological/non-pharmacological adherence. Therefore, the aim of the present short review is to describe the implications of cognitive impairment and psychosocial factors for clinical practice and disease management in COPD patients. Due to the interaction of these factors on adherence to rehabilitation programs, self-management and rehabilitation completion, future research should investigate simultaneously the role of all these different aspects to individuate a specific clinical approach that might include specific screening tools to evaluate cognitive impairment and psychosocial difficulties. A timely specific evaluation, within an interdisciplinary approach, could help to implement a more individualized and personalized treatment.

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“…Among these are patients’ education, values and preferences, media pressures, third payer’s convenience, legal fears and last (but hopefully not least…) clinical decision and competence by clinicians. Clinicians should tailor21 the best care for their individual patient on the basis of their experience, and according to the present scientific evidence it is here that, taken together, the three recent papers16–18 may be helpful in at least closing one chapter in the treatment of COPD and releasing the efforts of the patients and their carers for therapies of proven benefit.…”

mentioning

confidence: 96%

Inspiratory muscle training in COPD: can data finally beat emotion?

Polkey

Ambrosino

2018

Thorax

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Response to pulmonary rehabilitation: toward personalised programmes?

Cited by 30 publications

References 13 publications

COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

From Mild Cognitive Impairment (MCI) to Dementia in Chronic Obstructive Pulmonary Disease. Implications for Clinical Practice and Disease Management: A Mini-Review

Inspiratory muscle training in COPD: can data finally beat emotion?

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Response to pulmonary rehabilitation: toward personalised programmes?

Cited by 30 publications

References 13 publications

COPD patients&rsquo; self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

COPD patients&rsquo; self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

From Mild Cognitive Impairment (MCI) to Dementia in Chronic Obstructive Pulmonary Disease. Implications for Clinical Practice and Disease Management: A Mini-Review

Inspiratory muscle training in COPD: can data finally beat emotion?

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COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation