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Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study

BACKGROUND: The adherence to and clinical efficacy of pulmonary rehabilitation in idiopathic pulmonary fibrosis (IPF), particularly in comparison with COPD, remains uncertain. The objectives of this real-world study were to compare the responses of patients with IPF with a matched group of patients...

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Autores principales: Nolan, Claire M., Polgar, Oliver, Schofield, Susie J., Patel, Suhani, Barker, Ruth E., Walsh, Jessica A., Ingram, Karen A., George, Peter M., Molyneaux, Philip L., Maher, Toby M., Man, William D.-C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American College of Chest Physicians 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941605/
https://www.ncbi.nlm.nih.gov/pubmed/34699771
http://dx.doi.org/10.1016/j.chest.2021.10.021
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author Nolan, Claire M.
Polgar, Oliver
Schofield, Susie J.
Patel, Suhani
Barker, Ruth E.
Walsh, Jessica A.
Ingram, Karen A.
George, Peter M.
Molyneaux, Philip L.
Maher, Toby M.
Man, William D.-C.
author_facet Nolan, Claire M.
Polgar, Oliver
Schofield, Susie J.
Patel, Suhani
Barker, Ruth E.
Walsh, Jessica A.
Ingram, Karen A.
George, Peter M.
Molyneaux, Philip L.
Maher, Toby M.
Man, William D.-C.
author_sort Nolan, Claire M.
collection PubMed
description BACKGROUND: The adherence to and clinical efficacy of pulmonary rehabilitation in idiopathic pulmonary fibrosis (IPF), particularly in comparison with COPD, remains uncertain. The objectives of this real-world study were to compare the responses of patients with IPF with a matched group of patients with COPD undergoing the same supervised, outpatient pulmonary rehabilitation program and to determine whether pulmonary rehabilitation is associated with survival in IPF. RESEARCH QUESTION: Do people with IPF improve to the same extent with pulmonary rehabilitation as a matched group of individuals with COPD, and are noncompletion of or nonresponse to pulmonary rehabilitation, or both, associated with 1-year all-cause mortality in IPF? STUDY DESIGN AND METHODS: Using propensity score matching, 163 patients with IPF were matched 1:1 with a control group of 163 patients with COPD referred for pulmonary rehabilitation. We compared between-group pulmonary rehabilitation completion rates and response. Survival status in the IPF cohort was recorded over 1 year after pulmonary rehabilitation discharge. Cox proportional hazards regression explored the association between pulmonary rehabilitation status and all-cause mortality. RESULTS: Similar pulmonary rehabilitation completion rates (IPF, 69%; COPD, 63%; P = .24) and improvements in exercise response were observed in both groups with no significant mean between-group differences in incremental shuttle walk test (ISWT) change (mean, 2 m [95% CI, –18 to 22 m]). Pulmonary rehabilitation noncompletion (hazard ratio [HR], 5.62 [95% CI, 2.24-14.08]) and nonresponse (HR, 3.91 [95% CI, 1.54-9.93]) were associated independently with increased 1-year all-cause mortality in IPF. INTERPRETATION: This real-word study demonstrated that patients with IPF have similar completion rates and magnitude of response to pulmonary rehabilitation compared with a matched group of patients with COPD. In IPF, noncompletion of and nonresponse to pulmonary rehabilitation were associated with increased all-cause mortality. These data reinforce the benefits of pulmonary rehabilitation in patients with IPF.
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spelling pubmed-89416052022-04-05 Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study Nolan, Claire M. Polgar, Oliver Schofield, Susie J. Patel, Suhani Barker, Ruth E. Walsh, Jessica A. Ingram, Karen A. George, Peter M. Molyneaux, Philip L. Maher, Toby M. Man, William D.-C. Chest Diffuse Lung Disease: Original Research BACKGROUND: The adherence to and clinical efficacy of pulmonary rehabilitation in idiopathic pulmonary fibrosis (IPF), particularly in comparison with COPD, remains uncertain. The objectives of this real-world study were to compare the responses of patients with IPF with a matched group of patients with COPD undergoing the same supervised, outpatient pulmonary rehabilitation program and to determine whether pulmonary rehabilitation is associated with survival in IPF. RESEARCH QUESTION: Do people with IPF improve to the same extent with pulmonary rehabilitation as a matched group of individuals with COPD, and are noncompletion of or nonresponse to pulmonary rehabilitation, or both, associated with 1-year all-cause mortality in IPF? STUDY DESIGN AND METHODS: Using propensity score matching, 163 patients with IPF were matched 1:1 with a control group of 163 patients with COPD referred for pulmonary rehabilitation. We compared between-group pulmonary rehabilitation completion rates and response. Survival status in the IPF cohort was recorded over 1 year after pulmonary rehabilitation discharge. Cox proportional hazards regression explored the association between pulmonary rehabilitation status and all-cause mortality. RESULTS: Similar pulmonary rehabilitation completion rates (IPF, 69%; COPD, 63%; P = .24) and improvements in exercise response were observed in both groups with no significant mean between-group differences in incremental shuttle walk test (ISWT) change (mean, 2 m [95% CI, –18 to 22 m]). Pulmonary rehabilitation noncompletion (hazard ratio [HR], 5.62 [95% CI, 2.24-14.08]) and nonresponse (HR, 3.91 [95% CI, 1.54-9.93]) were associated independently with increased 1-year all-cause mortality in IPF. INTERPRETATION: This real-word study demonstrated that patients with IPF have similar completion rates and magnitude of response to pulmonary rehabilitation compared with a matched group of patients with COPD. In IPF, noncompletion of and nonresponse to pulmonary rehabilitation were associated with increased all-cause mortality. These data reinforce the benefits of pulmonary rehabilitation in patients with IPF. American College of Chest Physicians 2022-03 2021-10-23 /pmc/articles/PMC8941605/ /pubmed/34699771 http://dx.doi.org/10.1016/j.chest.2021.10.021 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Diffuse Lung Disease: Original Research
Nolan, Claire M.
Polgar, Oliver
Schofield, Susie J.
Patel, Suhani
Barker, Ruth E.
Walsh, Jessica A.
Ingram, Karen A.
George, Peter M.
Molyneaux, Philip L.
Maher, Toby M.
Man, William D.-C.
Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title_full Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title_fullStr Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title_full_unstemmed Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title_short Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study
title_sort pulmonary rehabilitation in idiopathic pulmonary fibrosis and copd: a propensity-matched real-world study
topic Diffuse Lung Disease: Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941605/
https://www.ncbi.nlm.nih.gov/pubmed/34699771
http://dx.doi.org/10.1016/j.chest.2021.10.021
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