Programas de Rehabilitación Respiratoria , Anotaciones Sobre Fenotipo Asma -EPOC

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.

Trial registration ISRCTN52403063.

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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 ).

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