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A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Authors Li Y, Feng J, Li Y, Jia W, Qian H

Received 2 September 2017

Accepted for publication 8 December 2017

Published 11 January 2018 Volume 2018:12 Pages 97—104

DOI https://doi.org/10.2147/PPA.S150679

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Naifeng Liu


Yi Li,1,2 Jing Feng,3,4 Yuechuan Li,2 Wei Jia,2 Hongyu Qian2

1Graduate School, Tianjin Medical University, 2Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, 3Respiratory Department, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 4Neuropharmacology Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA

Background: The benefit of pulmonary rehabilitation (PR) for patients with COPD diminishes over time. We investigated a new strategy involving home-visit and phone contact and compared this to usual care in maintenance of PR benefits.
Methods: A total of 172 stable COPD patients receiving 8-week PR program were recruited for this prospective study. Patients were allocated into usual care group (UC) and PR maintenance group (PRMG) randomly. Patients in PRMG participated in maintenance strategy at home under supervision through home-visit and phone contact. The 6-minute walking test (6MWT), COPD assessment test (CAT), and modified Medical Research Council scale (mMRC) scores were evaluated every 3 months.
Results: Of the total, 151 patients completed 8-week PR program with satisfactory PR results (p<0.001), and 104 patients finished the follow-up. The clinical improvements in 6MWT, CAT, and mMRC scores were maintained (p<0.001) in PRMG. In comparison, the benefit of PR diminished gradually in UC. The differences in 6MWT, CAT, and mMRC scores between groups were observed 6, 9, and 6 months after PR, respectively (p<0.05). Total frequency of exacerbations in PRMG was lower than UC (p=0.021).
Conclusion: Maintenance strategy involving home-visit and phone contact is superior to usual care to preserve PR benefits, and reduces the acute COPD exacerbation rate.

Keywords: COPD, pulmonary rehabilitation, 6-minute walking test, COPD assessment test, maintenance
 

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