S10 Effect of pulmonary rehabilitation in patients with co-existing COPD and heart failure: data from the 2015 national COPD audit programme

Abstract

Introduction and objectives Little is known on the uptake and completion of pulmonary rehabilitation (PR) in adults with COPD and either left or right heart failure (HF) (cor pulmonale [CP]). Furthermore, the responsiveness related to PR is unknown. The objectives were to explore completion rates and outcome measures in patients with COPD and co-existing HF or not, that were assessed for PR, using data from the 2015 National COPD Audit Programme, Royal College of Physicians. Methods PR services across England and Wales provided data for all consenting patients assessed for PR between Jan and April 2015. Descriptive statistics, t-tests and chi-square were used to explore data from patients with COPD +HF (collected as either left heart failure [LVF] or CP). Mixed 2 × 2 ANOVA’s were used to compare data between patients with COPD (with or without HF), before and after PR. Results 232/7134 (3.3%) patients with COPD+HF (32% females, mean [SD] age 74.5 [10.0] years; males 72.2 [9.2] years) were assessed for PR. Of those, 85% (n=196) enrolled into PR and of these 196, 65% (n=128) completed. In those with co-existing HF, there was no difference in age or gender between PR completers and non-completers (73.1+9.1 vs 72.7+10.1 years p=0.74, and 66% vs 71% males, respectively). Exercise capacity (assessed by the ISWT) increased after PR (mean[SD] 41.8 [49.8]m) in patients with COPD+HF (n=66) (t(65)=-6.8, p Conclusion Nationally, 3.3% of patients with COPD assessed for PR had documented HF. Over half (55%) of those assessed with COPD +HF completed PR. Those without HF improved their exercise capacity (ISWT) more compared to those with HF. The improvements in HRQOL and functional capacity were similar.