The effectiveness of a structured education pulmonary rehabilitation programme for improving the health status of people with moderate and severe COPD in primary care.
- Published Online First 4 June 2013
- ABSTRACT
Objective To evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).
Design Two-arm, cluster randomised controlled trial.
Setting 32 general practices in the Republic of Ireland.
Participants 350 participants with a diagnosis of moderate or severe COPD.
Intervention Experimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.
Main outcome measure Health status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12–14 weeks postcompletion of the programme.
Results Participants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.
Conclusions A primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.
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Consideremos el Fenotipo Asma-EPOC
Asthma-COPD overlap syndrome:
Libre traducción jhs:
Conclusión:
El asma
y la EPOC afecta más de
1 en 8
adultos mayores de
20 años.
La coexistencia
de ambas enfermedades se presenta en
una proporción substancial de sujetos , su prevalencia aumenta con la edad.
Pacientes con síndrome asma-EPOC,
parecen pertenecer a un
fenotipo , con más
problemas respiratorios, síntomas
, dificultad para
realizar sus tareas
diarias ( impairment), con
un patrón de mayor
uso y consumo
de recursos médicos,
con un patrón peculiar
de factores de riesgo, si se
comparan al EPOC
o asma solos.
Es necesario
enfocar la investigación a
esta síndrome asma-EPOC, mejorar su monitoreo y tratamiento.
( Asthma-COPD
overlap síndrome ).
