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Efficacy of supervised maintenance exercise following pulmonary rehabilitation on health care use: a systematic review and meta-analysis

Alex R Jenkins, Holly Gowler, Ffion Curtis, et al.
Int J Chron Obstruct Pulmon Dis 2018;13:257–73

Pulmonary rehabilitation (PR) is a known high-value health intervention for those diagnosed with chronic obstructive lung disease (COPD). However, the health benefits associated with PR are often short term, with the condition of most patients returning to baseline 12 months after treatment. Interest has therefore increased in exploring potential maintenance programmes that can help prolong the health benefits associated with PR. In this meta-analysis, Alex R Jenkins from the University of Lincoln and colleagues reviewed eight studies, covering 790 COPD patients. Its aim was to explore the clinical benefits associated with continued supervised maintenance exercise programmes in COPD patients following PR as opposed to usual care. Results showed that implementing such exercise programmes significantly reduced the risk of at least one respiratory-cause hospital admission, along with the overall risk of an exacerbation in COPD patients. Reduction in length of stay and rate of respiratory-cause hospital admissions were also noted. The clinical significance associated with implementing maintenance programmes in COPD patients provides hope for improving patient outcomes and reducing healthcare use in COPD. The authors concluded that this is the start in a step towards building an evidence base for the use of continued maintenance exercise programmes in patients completing PR.

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