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Effects of pulmonary rehabilitation on exacerbation number and severity in people with COPD

Elizabeth Moore, Roger Newson, Miland Joshi, et al.
Chest 2017;152(6):1188–1202.
doi: 10.1016/j.chest.2017.05.006

Acute exacerbations in chronic obstructive pulmonary disease (COPD) negatively affect health-related quality of life, and pulmonary rehabilitation (PR) is a key component of COPD management. Clear evidence of the benefits of PR on reducing hospital admissions is lacking, since there are no studies on the effect of PR in reducing hospital admissions or milder general practice (GP)-treated events, especially in patients with less severe COPD (who comprise most referrals for PR). In this cohort study, using primary care data from the UK Clinical Practice Research Datalink and Hospital Episode Statistics, Elizabeth Moore and colleagues compared the rates of hospitalised and GP-treated COPD acute exacerbations prior to and following PR. They found less than 10% of patients eligible for PR were referred, and that the number of acute exacerbations for patients referred for PR was no lower than for those who were not referred. PR had no detectable effect on exacerbation frequency. The authors proposed that the national COPD audit should monitor the content of rehabilitation more closely.

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