Pulmonary rehabilitation for acute exacerbations of chronic obstructive pulmonary disease (COPD): A systematic review

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Title: Pulmonary rehabilitation for acute exacerbations of chronic obstructive pulmonary disease (COPD): A systematic review
Authors: Moore, E
Palmer, T
Newson, R
Quint, JK
Soljak, M
Item Type: Conference Paper
Abstract: Background: Acute exacerbations of COPD (AECOPD) have a significant impact on healthcare utilisation, including physician visits and hospitalisations. The effect of pulmonary rehabilitation (PR) on hospitalisations for AECOPD is inconclusive. Methods: Medical databases were searched to assess the impact of PR on emergency hospitalisations for AECOPD. Cohort studies and randomised controlled trials (RCTs) reporting hospitalisations for AECOPD as an outcome were included. Meta-analyses compared exacerbation rates between eligible PR recipients and non-recipients before and after PR. Results: 18 studies were included in the meta-analysis. Admission rates per person-year were lower in the year following completion of PR. Results from 10 RCTs showed that the control groups had a higher overall rate of exacerbations than the PR groups (0.967, 95% confidence intervals (CIs) 0.669, 1.399 for control versus 0.615 95% CI 0.328, 1.155 for PR). Five studies compared admission numbers in the 12 months before and after PR, finding a significantly higher admission rate before (1.243, 95% CIs 0.661, 2.336) compared to after PR (0.472, 95% CIs 0.280, 0.794). The pooled result of three cohort studies found the reference group had a lower admission rate compared to the PR group (0.184, 95% CI 0.106, 0.317 for reference versus 0.282 95% CI 0.246, 0.323 for PR). Conclusions: Although results from RCTs suggested that PR reduces subsequent exacerbations, pooled results from the cohort studies did not favour PR, likely reflecting the heterogeneous nature of individuals included in observational research and the varying standards of PR programmes.
Issue Date: 8-Nov-2016
Date of Acceptance: 23-May-2016
URI: http://hdl.handle.net/10044/1/33186
DOI: https://dx.doi.org/10.1183/13993003.congress-2016.PA3771
ISSN: 0903-1936
Publisher: European Respiratory Society
Start Page: PA3771
End Page: PA3771
Journal / Book Title: European Respiratory Journal
Volume: 48
Issue: Suppl 60
Copyright Statement: Copyright ┬ęthe authors 2016
Sponsor/Funder: The Chartered Society of Physiotherapy
Funder's Grant Number: 131105
Conference Name: European Respiratory Society Congress 2016
Keywords: 11 Medical And Health Sciences
Respiratory System
Publication Status: Published
Start Date: 2016-09-03
Finish Date: 2016-09-07
Conference Place: London
Appears in Collections:Infectious Disease Epidemiology
National Heart and Lung Institute
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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