Pulmonary Rehabilitation for COPD May Be Effective Regardless of Socioeconomic Status, Study Finds

November 9, 2019

Socially deprived patients were younger, more frequently women, active smokers, living alone, and belonged to lower socioprofessional categories when compared with the non-socially deprived group, but they still benefitted from home-based pulmonary rehabilitation.

Home-based pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) may be effective in the short-term and long-term, regardless of the patient’s socioeconomic status, according to research published in the International Journal of Chronic Obstructive Pulmonary Disease

A retrospective observational study, aimed at determining the impact of socioeconomic deprivation on PR outcomes for COPD, enrolled 459 patients who were separated into socially deprived and non-socially deprived groups based on the Evaluation of Deprivation and Inequalities in Health Centers (EPICES) questionnaire. The patients participated in PR rehabilitation which involved once-weekly home sessions for 8 weeks and an individualized plan of retraining exercises, physical activities, therapeutic education, and psychosocial and motivational support.

“Pulmonary rehabilitation (PR) is a validated and widely used approach to improve dyspnea, exercise tolerance, quality of life, anxiety, and depression over the short and long term in patients with chronic obstructive pulmonary disease (COPD),” noted the authors. “The beneficial effects of PR are independent of the severity of disease, including chronic respiratory failure requiring long-term oxygen therapy (LTOT) and/or noninvasive ventilation (NIV), and of the PR modalities, particularly whether they are inpatient vs outpatient or home-based programs.”

The researchers also utilized the 6 min stepper test (6MST), Hospital Anxiety and Depression Scale (HADS), and Visual Simplified Respiratory Questionnaire (VSRQ) to assess exercise tolerance, anxiety, depression, and quality of life at baseline and at 2, 8, and 14 months after.

According to the results, socially deprived patients were younger, more frequently women, active smokers, living alone, and belonged to lower socioprofessional categories when compared with the non-socially deprived group. Additionally, at baseline, 6MST, VSRQ, and HADS measures were lower for the socially deprived group than the non-socially deprived group. During the follow-ups, the researchers found no significant between-group differences in any outcome, whereas the percentage of patients with clinically important improvements remained the same.

“In conclusion, this study shows that, although social deprivation is associated with impaired exercise tolerance and quality of life and higher levels of depression and anxiety in COPD patients, home-based PR results in similar improvements in these outcomes in the short, medium, and long term, regardless of socioeconomic status,” concluded the researchers.

Reference

Grosbois J, Heluain-Robiquet J, et al. Influence of socioeconomic deprivation on short- and long-term outcomes of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease [published online October 31, 2019]. Int J Chron Obstruct Pulmon Dis. doi: 10.2147/COPD.S224348.