Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits
| Autor: | Ioannis Vogiatzis, Stavroula Spetsioti, Zafeiris Louvaris, Georgios Kaltsakas, Konstantinos Kostikas, Andriana I. Papaioannou, Maroula Vasilopoulou, Nikolaos Chynkiamis, Sofia Antiopi Genimata, Nikolaos Koulouris, Eleni Kortianou, Anastasios Palamidas |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Risk Pediatrics medicine.medical_specialty medicine.medical_treatment Lower risk Rate ratio law.invention 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Quality of life Randomized controlled trial law Predictive Value of Tests Outpatients medicine Humans Pulmonary rehabilitation 030212 general & internal medicine Exercise Aged Telerehabilitation COPD Rehabilitation business.industry Emergency department Middle Aged medicine.disease Home Care Services Hospitals B900 Hospitalization 030228 respiratory system Research Design Emergency medicine Acute Disease Multivariate Analysis Disease Progression Quality of Life Patient Compliance Female business Emergency Service Hospital |
| Zdroj: | The European respiratory journal. 49(5) |
| ISSN: | 1399-3003 0903-1936 |
| Popis: | Pulmonary rehabilitation (PR) remains grossly underutilised by suitable patients worldwide. We investigated whether home-based maintenance tele-rehabilitation will be as effective as hospital-based maintenance rehabilitation and superior to usual care in reducing the risk for acute chronic obstructive pulmonary disease (COPD) exacerbations, hospitalisations and emergency department (ED) visits.Following completion of an initial 2-month PR programme this prospective, randomised controlled trial (between December 2013 and July 2015) compared 12 months of home-based maintenance tele-rehabilitation (n=47) with 12 months of hospital-based, outpatient, maintenance rehabilitation (n=50) and also to 12 months of usual care treatment (n=50) without initial PR.In a multivariate analysis during the 12-month follow-up, both home-based tele-rehabilitation and hospital-based PR remained independent predictors of a lower risk for 1) acute COPD exacerbation (incidence rate ratio (IRR) 0.517, 95% CI 0.389–0.687, and IRR 0.635, 95% CI 0.473–0.853), respectively, and 2) hospitalisations for acute COPD exacerbation (IRR 0.189, 95% CI 0.100–0.358, and IRR 0.375, 95% CI 0.207–0.681), respectively. However, only home-based maintenance tele-rehabilitation and not hospital-based, outpatient, maintenance PR was an independent predictor of ED visits (IRR 0.116, 95% CI 0.072–0.185).Home-based maintenance tele-rehabilitation is equally effective as hospital-based, outpatient, maintenance PR in reducing the risk for acute COPD exacerbation and hospitalisations. In addition, it encounters a lower risk for ED visits, thereby constituting a potentially effective alternative strategy to hospital-based, outpatient, maintenance PR. |
| Databáze: | OpenAIRE |
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