dc.contributor.author |
Eaton, T |
en |
dc.contributor.author |
Young, P |
en |
dc.contributor.author |
Fergusson, W |
en |
dc.contributor.author |
Moodie, L |
en |
dc.contributor.author |
Zeng, Sui |
en |
dc.contributor.author |
O'Kane, F |
en |
dc.contributor.author |
Good, N |
en |
dc.contributor.author |
Rhodes, L |
en |
dc.contributor.author |
Poole, Phillippa |
en |
dc.contributor.author |
Kolbe, John |
en |
dc.date.accessioned |
2012-03-12T02:20:31Z |
en |
dc.date.accessioned |
2012-05-01T03:45:11Z |
en |
dc.date.issued |
2009-03 |
en |
dc.identifier.citation |
Respirology 14(2):230-238 Mar 2009 |
en |
dc.identifier.issn |
1323-7799 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/17639 |
en |
dc.description.abstract |
In COPD, hospital admissions and readmissions account for the majority of health-care costs. The aim of this prospective randomized controlled study was to determine if early pulmonary rehabilitation, commenced as an inpatient and continued after discharge, reduced acute health-care utilization.Consecutive COPD patients (n = 397), admitted with an exacerbation, were screened: 228 satisfied the eligibility criteria, of whom 97 consented to randomization to rehabilitation or usual care. Both intention-to-treat and per-protocol analyses are reported with adherence being defined a priori as participation in at least 75% of rehabilitation sessions.The participants were elderly with severe impairment of pulmonary function, poor health-related quality of life and high COPD-related morbidity. The rehabilitation group demonstrated a 23% (95% CI: 11-36%) risk of readmission at 3 months, with attendees having a 16% (95% CI: 0-32%) risk compared with 32% (95% CI: 19-45%) for usual care. These differences were not significant. There were a total of 79 COPD-related readmission days (1.7 per patient, 95% CI: 0.6-2.7, P = 0.19) in the rehabilitation group, compared with 25 (1.3 per patient, 95% CI: 0-3.1, P = 0.17) for the attendees and 209 (4.2 per patient, 95% CI: 1.7-6.7) for usual care. The BMI, airflow obstruction, dyspnoea and exercise capacity index showed a non-significant trend to greater improvement among attendees compared with those receiving usual care (5.5 (2.3) and 5.6 (2.7) at baseline, improving to 3.7 (1.9) and 4.5 (2.5), respectively, at 3 months). No adverse effects were identified.Early inpatient-outpatient rehabilitation for COPD patients admitted with an exacerbation was feasible and safe, and was associated with a non-significant trend towards reduced acute health-care utilization. |
en |
dc.language |
EN |
en |
dc.publisher |
WILEY-BLACKWELL PUBLISHING, INC |
en |
dc.relation.ispartofseries |
Respirology |
en |
dc.relation.replaces |
http://hdl.handle.net/2292/13838 |
en |
dc.relation.replaces |
2292/13838 |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1323-7799/ |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.subject |
acute health-care utilization |
en |
dc.subject |
COPD |
en |
dc.subject |
exacerbation |
en |
dc.subject |
hospital admission |
en |
dc.subject |
pulmonary rehabilitation |
en |
dc.subject |
6-MINUTE WALK TEST |
en |
dc.subject |
RESPIRATORY REHABILITATION |
en |
dc.subject |
EXERCISE CAPACITY |
en |
dc.subject |
PHYSICAL-ACTIVITY |
en |
dc.subject |
LUNG-DISEASE |
en |
dc.subject |
INDEX |
en |
dc.subject |
HOSPITALIZATION |
en |
dc.subject |
QUESTIONNAIRE |
en |
dc.subject |
IMPROVEMENTS |
en |
dc.subject |
MORTALITY |
en |
dc.title |
Does early pulmonary rehabilitation reduce acute health-care utilization in COPD patients admitted with an exacerbation? A randomized controlled study |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1111/j.1440-1843.2008.01418.x |
en |
pubs.issue |
2 |
en |
pubs.begin-page |
230 |
en |
pubs.volume |
14 |
en |
dc.rights.holder |
Copyright: the authors; journal compilation; Asian Pacific Society of Respirology |
en |
dc.identifier.pmid |
19272084 |
en |
pubs.end-page |
238 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
85861 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
en |
pubs.record-created-at-source-date |
2010-09-01 |
en |
pubs.dimensions-id |
19272084 |
en |