Does pulmonary rehabilitation give additional benefits to primary care patients with chronic obstructive pulmonary disease? Results from a randomized controlled clinical trial in Hong Kong Chinese
Author(s)
Author(s)
Lindsay, M.
Chan, K.
Poon, P.
Liu, K. H.
Wong, W. C. W.
Wong, S.
Lau, L.
Date Issued
2004
Conference
The 9th Congress of the Asian Pacific Society of Respirology
Abstract
Objectives: To evaluate the effectiveness of a multidisciplinary pulmonary rehabilitation programme in patients with COPD in a primary care setting.
Design: A randomized controlled clinical trial to analyse the difference in outcomes of COPD patients receiving usual medical treatment plus pulmonary rehabilitation versus medical treatment alone. Setting: Two primary care teaching clinics affiliated with a university which serves a population of 600 000. Participants: Forty-six primary care patients. Methods: Fifty subjects underwent spirometry to confirm their status of COPD. They were then assessed by the 6 Minute Walking Distance (6MWD) and the Visual Analogue Scale (Peak VAS) to evaluate their disease severity. This was further supplemented by the Chronic Respiratory Disease Questionnaire (CRQ). All 50 subjects were given tiotropium to optimise their treatment. After a 6-week period, half were randomized to the intervention group (i.e. receiving pulmonary rehabilitation), while the rest were randomized to receive only medical care (control). Spirometry, 6MWD, Peak VAS & CRQ were performed in both groups at 6 weeks, 12 weeks and 6 months. Main Outcome Measures: Performance on Spirometry, 6MWD, Peak VAS and CRQ. Results: Significant improvement (P < 0.05) in performance was seen in 6MWD, symptoms of dyspnoea measured by Peak VAS and CRQ. The improvement was sustained at the time of follow up at 6 months. However, no additional significant improvement in performance was seen in the intervention group when compared to control. Conclusion: Tiotropium therapy has improved health outcomes in patients presented with COPD in primary care settings. A 6 weekly Pulmonary Rehabilitation Programme did not give any additional benefits in patients already given tiotropium.
Design: A randomized controlled clinical trial to analyse the difference in outcomes of COPD patients receiving usual medical treatment plus pulmonary rehabilitation versus medical treatment alone. Setting: Two primary care teaching clinics affiliated with a university which serves a population of 600 000. Participants: Forty-six primary care patients. Methods: Fifty subjects underwent spirometry to confirm their status of COPD. They were then assessed by the 6 Minute Walking Distance (6MWD) and the Visual Analogue Scale (Peak VAS) to evaluate their disease severity. This was further supplemented by the Chronic Respiratory Disease Questionnaire (CRQ). All 50 subjects were given tiotropium to optimise their treatment. After a 6-week period, half were randomized to the intervention group (i.e. receiving pulmonary rehabilitation), while the rest were randomized to receive only medical care (control). Spirometry, 6MWD, Peak VAS & CRQ were performed in both groups at 6 weeks, 12 weeks and 6 months. Main Outcome Measures: Performance on Spirometry, 6MWD, Peak VAS and CRQ. Results: Significant improvement (P < 0.05) in performance was seen in 6MWD, symptoms of dyspnoea measured by Peak VAS and CRQ. The improvement was sustained at the time of follow up at 6 months. However, no additional significant improvement in performance was seen in the intervention group when compared to control. Conclusion: Tiotropium therapy has improved health outcomes in patients presented with COPD in primary care settings. A 6 weekly Pulmonary Rehabilitation Programme did not give any additional benefits in patients already given tiotropium.
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