Relationship between pulmonary rehabilitation and care dependency in COPD

Janssen, Daisy J.A.; Wilke, Sarah; Smid, Dionne E.; Franssen, Frits M.E.; Augustin, Ingrid; Wouters, Emiel F.M.; Spruit, Martijn A.

doi:10.1136/thoraxjnl-2016-208836

Cited by 17 publications

(13 citation statements)

References 9 publications

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“…The mean baseline 6MWD was 424 ± 124 m and 25.1% of the patients had a 6MWD below 350 m [40] and in 74.7% of the patients, quadriceps muscle strength was less than 80% of the predicted value [41]. The PROs showed a high degree of dyspnea (80.7% with mMRC dyspnea grade of two or higher) [22], anxiety (34.8% with ≥10 points) [32], depression (33.4% with ≥10 points) [32], care dependency (28.5% with CDS total score of ≤68 points) [25], and an impaired HRQoL (81.9% with a SGRQ total score of ≥44 points; 75.0% with a CAT total score of ≥18 points; 76.7% CCQ total score of ≥1.9 points) [22]. Baseline characteristics, exercise test outcomes and PROs at baseline are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation

Meys

Stoffels

Houben-Wilke

et al. 2020

Health Qual Life Outcomes

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Background: Over the years, the scope of outcomes assessment in chronic obstructive pulmonary disease (COPD) has broadened, allowing for the evaluation of various patient-reported outcomes (PROs). As it still remains unclear whether and to what extent PROs mirror the exercise performance of patients with COPD, the current study aimed to assess the association between different exercise test outcomes and PROs, before and after pulmonary rehabilitation (PR). Methods: Correlations between PROs used to describe health-related quality of life (HRQoL), mood status, level of care dependency and dyspnea in patients with COPD and commonly used laboratory-and field-based exercise test outcomes were evaluated in 518 individuals with COPD attending PR. Results: Overall, correlations between PROs and exercise test outcomes at baseline were statistically significant. The correlation between modified Medical Research Council (mMRC) dyspnea score and 6-min walking distance (6MWD) was strongest (ρ:-0.65; p<0.001). HRQoL related PROs showed weak correlations with exercise outcomes at baseline. Moderate correlations were found between St George's Respiratory Questionnaire total score and 6MWD (r:-0.53; p<0.001) and maximal workload achieved during cardiopulmonary exercise testing (ρ:-0.48; p<0.001); and between Clinical COPD Questionnaire (CCQ) total score and 6MWD (r:-0.48; p<0.001) and maximal workload (ρ:-0.43; p<0.001). When significant, correlations between changes in exercise test outcomes and changes in PROs after PR were generally very weak or weak. The highest correlation was found between changes in CCQ total score and changes in 6MWD (ρ: − 0.36; p<0.001).

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Section: Resultsmentioning

confidence: 99%

“…Patients between the age of 40 and 85 years with a diagnosis of COPD according to GOLD guidelines [22] were eligible. The protocol and part of the results of the Chance-study have been published before [1,4,10,15,19,[23][24][25][26]. All patients gave written informed consent prior to inclusion in the study.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation

Meys

Stoffels

Houben-Wilke

et al. 2020

Health Qual Life Outcomes

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“…The Patient Information Form was developed by the authors based on existing literature and consisted of 10 questions regarding age, sex, smoking status, time of COPD diagnosis, the forced expiratory volume in 1 second (FEV1), the forced volume capacity (FVC), and Tiffeneau-Pinelli index (FEV1/ FVC) values, stage of COPD, O 2 support at home, and drug regimens. 27,[33][34][35][36][37] The Dyspnea-12 Scale measures the severity of breathlessness and consists 12 items. Each item is rated on a 4-point Likert scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe).…”

Section: Measurementsmentioning

confidence: 99%

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

Helvaci

Metin

Özdemir

et al. 2019

Home Health Care Management & Practice

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The aim of this feasibility study was to determine the effects of a nurse-led education and counseling program for chronic obstructive pulmonary disease (COPD-ECP) on dyspnea, health status, and care dependency in patients. A quasi-experimental, pre-posttest research design without a control group was performed on 30 COPD patients. The patients received an 8-week COPD-ECP via home visits during the first 4 weeks and via phone interviews in the subsequent 4 weeks. After completion of COPD-ECP and a 4-week break, a final follow-up was conducted at the end of 12th week. The Dyspnea-12, COPD Assessment Test (CAT), and Care Dependency Scale (CDS) scores were calculated during the first interview, and on the 4th, 8th, and 12th week of the study. The patients completed all sessions of COPD-ECP without side effects. There was a significant decrease in the total Dyspnea-12 scores at the end of the study period. Compared to the baseline assessment, CAT total scores significantly decreased in the 4th, 8th, and 12th week ( p < 0.05), and CDS scores showed a significant reduction at the 12th week ( p < 0.05). In conclusion, COPD-ECP is feasible in regular clinical practice and well accepted by patients, and it seems to improve health status and decrease dyspnea, and care dependency. Future randomized controlled studies are warranted to explore the effects of COPD-ECP on fatigue, cough and sleep problems, and the best innovative strategies to improve the efficiency of COPD-ECP.

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“…Interestingly, the identified factors are all (at least to some extent) possible treatment targets. Indeed, education may increase patients' knowledge, exercise can reduce TUG-time, pulmonary rehabilitation can reduce the degree of care dependency, and smoking cessation can reduce the number of active smokers [54,59].…”

Section: Predictors Of Ecopd-related Hospital Admissionmentioning

confidence: 99%

Physical, Psychological, and Social Factors Associated with Exacerbation-Related Hospitalization in Patients with COPD

Crutsen

Keene

Janssen

et al. 2020

JCM

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Background and objective: Exacerbation(s) of chronic obstructive pulmonary disease (eCOPD) entail important events describing an acute deterioration of respiratory symptoms. Changes in medication and/or hospitalization are needed to gain control over the event. However, an exacerbation leading to hospitalization is associated with a worse prognosis for the patient. The objective of this study is to explore factors that could predict the probability of an eCOPD-related hospitalization. Methods: Data from 128 patients with COPD included in a prospective, longitudinal study were used. At baseline, physical, emotional, and social status of the patients were assessed. Moreover, hospital admission during a one year follow-up was captured. Different models were made based on univariate analysis, literature, and practice. These models were combined to come to one final overall prediction model. Results: During follow-up, 31 (24.2%) participants were admitted for eCOPD. The overall model contained six significant variables: currently smoking (OR = 3.93), forced vital capacity (FVC; OR = 0.97), timed-up-and-go time (TUG-time) (OR = 14.16), knowledge (COPD knowledge questionnaire, percentage correctly answered questions (CIROPD %correct )) (<60% (OR = 1.00); 60%-75%: (OR = 0.30); >75%: (OR = 1.94), eCOPD history (OR = 9.98), and care dependency scale (CDS) total score (OR = 1.12). This model was well calibrated (goodness-of-fit test: p = 0.91) and correctly classified 79.7% of the patients. Conclusion: A combination of TUG-time, eCOPD-related admission(s) prior to baseline, currently smoking, FVC, CDS total score, and CIROPD %correct allows clinicians to predict the probability of an eCOPD-related hospitalization.

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Relationship between pulmonary rehabilitation and care dependency in COPD

Abstract: NTR3416 (The Netherlands).

Cited by 17 publications

References 9 publications

Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation

Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

Physical, Psychological, and Social Factors Associated with Exacerbation-Related Hospitalization in Patients with COPD

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