Background: Pulmonary Rehabilitation provides a comprehensive intervention for patients with chronic respiratory diseases. Outcome assessments are used to quantify the improvement in various areas of therapy like optimizing functional status. Since identification of additional benefits cannot be detected by usual measures, determination of other factors is considered to ensure success.
Method: Patients with COPD were enrolled in an 8 week out-patient program. They underwent pre and postrehabilitation evaluation that included Spirometry, Six-Minute Walk Test (6MWT) and cardiopulmonary exercise testing. Subjects completed a self-administered respiratory questionnaire using St. George Respiratory Questionnaire (SGRQ) and Medical Research Council Dyspnea Scale (MRC). Successful primary outcome was defined as greater than the minimum clinically important difference in one or more areas of attendance, MMRC, SGRQ and 6MWT.
Results: In total, 320 patients completed the study. At baseline, data showed educational attainment and distance between the facility and patients' residence were significant factors that determine success in the program at p-value 0.009 and 0.013 respectively. Age, gender, civil status, weight, height and Body Mass Index (BMI) showed no significant correlation. Impact of single or aggregated co-morbidities on the effect of the program was also significant at p-value 0.004. Advanced stage of COPD is associated with poor outcome. Significant correlations were found with outcome, presence of hypoxemia and episodes of exacerbations. Patients with partial pressure of oxygen at >80 mmHg (72.8%) and experiencing less than twice a year exacerbations (97.8%) were noted to have more successful outcome.
Conclusion: Educational attainment, distance between the facility and patient's residence, number of co-morbidities, severity of COPD, degree of hypoxemia and episodes of exacerbations determined the outcome of pulmonary rehabilitation program. These were statistically significant and clinically important in the improvement of the quality of life of COPD patients.