Effectiveness of pulmonary rehabilitation in individuals with Chronic Obstructive Pulmonary Disease according to inhaled therapy: The Maugeri study.
Airflow limitation
Bronchodilators
CAT
COPD triple therapy
Dyspnoea
Exercise capacity
Exercise training
Inhaled steroids
Journal
Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
28
06
2022
revised:
18
08
2022
accepted:
22
08
2022
pubmed:
18
9
2022
medline:
28
9
2022
entrez:
17
9
2022
Statut:
ppublish
Résumé
Real-life studies report discordant prescribing of inhaled triple therapy (TT) among individuals with COPD. Guidelines recommend pulmonary rehabilitation (PR) for persistent breathlessness and/or exercise limitation. This real-life study aimed to assess the effects of in-patient PR in individuals under TT as compared to other inhaled therapies (no TT). Multicentric, retrospective analysis of data from individuals admitted to in-hospital PR. Baseline characteristics were recorded and lung function was assessed. Outcome measures were: 6-min walking test (6MWT: primary outcome), Medical Research Council (MRC) scale for dyspnoea, and COPD assessment test (CAT). Data of pre and post program 6MWT of 1139 individuals were available. Pulmonary rehabilitation resulted in significant improvement in 6MWT in both groups, however, the effect size (by 54.3 ± 69.7 vs 42.5 ± 64.2 m, p = 0.004) and proportion of individuals reaching the minimal clinically important difference (MCID) of 6MWT (64.2%, vs 54.3%, p = 0.001) were higher in TT group. Both groups significantly improved also the other outcome measures. The significant independent predictors of reaching the MCID of 6MWT were hospital provenience, TT use, and high eosinophils count. Pulmonary rehabilitation results in significant benefits in individuals with COPD irrespective of the use of TT. However, individuals under TT report larger benefits in exercise tolerance than those under no TT.
Sections du résumé
BACKGROUND AND AIM
Real-life studies report discordant prescribing of inhaled triple therapy (TT) among individuals with COPD. Guidelines recommend pulmonary rehabilitation (PR) for persistent breathlessness and/or exercise limitation. This real-life study aimed to assess the effects of in-patient PR in individuals under TT as compared to other inhaled therapies (no TT).
METHODS
Multicentric, retrospective analysis of data from individuals admitted to in-hospital PR. Baseline characteristics were recorded and lung function was assessed. Outcome measures were: 6-min walking test (6MWT: primary outcome), Medical Research Council (MRC) scale for dyspnoea, and COPD assessment test (CAT).
RESULTS
Data of pre and post program 6MWT of 1139 individuals were available. Pulmonary rehabilitation resulted in significant improvement in 6MWT in both groups, however, the effect size (by 54.3 ± 69.7 vs 42.5 ± 64.2 m, p = 0.004) and proportion of individuals reaching the minimal clinically important difference (MCID) of 6MWT (64.2%, vs 54.3%, p = 0.001) were higher in TT group. Both groups significantly improved also the other outcome measures. The significant independent predictors of reaching the MCID of 6MWT were hospital provenience, TT use, and high eosinophils count.
CONCLUSION
Pulmonary rehabilitation results in significant benefits in individuals with COPD irrespective of the use of TT. However, individuals under TT report larger benefits in exercise tolerance than those under no TT.
Identifiants
pubmed: 36115316
pii: S0954-6111(22)00232-3
doi: 10.1016/j.rmed.2022.106967
pii:
doi:
Substances chimiques
Bronchodilator Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106967Informations de copyright
Copyright © 2022. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors have no conflict of interest to disclose related to this manuscript.