Abstract
Background: the effect of pulmonary rehabilitation (PR) services, beyond research contexts, on patients with lung diseases other than COPD requires further study. Objectives: to (i) assess the impact of a publicly funded PR on patients’ exercise capacity, self-efficacy, and health-related quality of life (HRQoL), and (ii) explore whether the effects vary across lung diseases. Methods: this retrospective pre–post study analyzed data from the Winnipeg Regional Health Authority PR program between 2016 and 2019. Results: 682 patients completed the full PR program. Pooled analyses found significant improvements in the patients’ exercise capacity (six-minute walk test (6MWT) (13.6%), fatigue (10.3%), and dyspnea (6.4%)), Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEMCD6) (11.6%), and HRQoL (Clinical COPD Questionnaire (CCQ) (18.5%) and St George’s Respiratory Questionnaire (SGRQ) (10.9%)). The analyses conducted on sub-groups of patients with chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, interstitial lung diseases (ILDs), other restrictive lung diseases (e.g., obesity, pleural effusion, etc.), lung cancer, and pulmonary hypertension (PH) indicated that, except for patients with PH, all the patients improved in the 6MWT. Fatigue decreased in patients with COPD, ILDs, and other restrictive lung diseases. Dyspnea decreased in patients with COPD, asthma, and lung cancer. SEMCD6 scores increased in COPD, ILDs and PH patients. CCQ scores decreased in all lung diseases, except lung cancer and PH. SGRQ scores only decreased in patients with COPD. Conclusion: PR services had a significant impact on patients with different lung diseases. Therefore, publicly funded PR should be available as a critical component in the management of patients with these diseases.
Highlights
Respiratory diseases are among the top leading causes of disease, death, and disability globally
Some studies have explored the effect of Pulmonary rehabilitation (PR) in real-life settings [10,11], the impact of PR has been mainly reported in the context of research studies, and there is still a gap in the knowledge regarding the benefits of pulmonary rehabilitation services in the real world [8,12]
The American Thoracic Society (ATS) and the European Respiratory Society (ERS) indicated that more information is needed regarding the benefits of repeated courses of PR, suggested that healthcare professionals should conduct pragmatic “real-word” trials of PR, and recommended that further research should be undertaken to assess the impact of PR program funding sources on patient use [12]
Summary
Respiratory diseases are among the top leading causes of disease, death, and disability globally. Pulmonary rehabilitation (PR) is defined as a “comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors” [2]. This non-pharmacological intervention is known to decrease symptoms (dyspnea and fatigue), improve exercise tolerance and quality of life, reduce healthcare utilization, as well as increase physical activity among patients with COPD [3]. The objectives of this study were to (i) assess the impact of a regional publicly funded pulmonary rehabilitation program on patients’ exercise capacity, self-efficacy, and health-related quality of life, and (ii) explore whether effects vary across lung diseases
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