PMID- 25166259
OWN - NLM
STAT- MEDLINE
DCOM- 20150709
LR  - 20151119
IS  - 1932-751X (Electronic)
IS  - 1932-7501 (Linking)
VI  - 34
IP  - 6
DP  - 2014 Nov-Dec
TI  - Veterans with chronic obstructive pulmonary disease achieve clinically relevant 
      improvements in respiratory health after pulmonary rehabilitation.
PG  - 420-9
LID - 10.1097/HCR.0000000000000079 [doi]
AB  - PURPOSE: To measure respiratory health and respiratory-related (RR) health care 
      utilization in veterans with chronic obstructive pulmonary disease referred to 
      pulmonary rehabilitation (PR) at the Cincinnati Veterans Administration (VA) 
      Medical Center. METHODS: We reviewed the records of 430 patients referred for PR 
      from 2008 to 2010: 78 met inclusion criteria and completed PR (PR group); 92 
      qualified for PR but declined participation (referral group). All PR participants 
      completed the St. George's Respiratory Questionnaire (SGRQ), BODE index, 6-minute 
      walk test (6MWT), UCSD Shortness of Breath Questionnaire (UCSDSOBQ), Pulmonary 
      Disease Knowledge Test, and self-reported use of short-acting bronchodilators 
      before and after PR. All VA health care encounters during the 12 months before 
      and after PR (PR group) or referral (referral group) were reviewed. RESULTS: 
      Respiratory health improved after PR: SGRQ (60.6 +/- 15.1, 51.1 +/- 16.7), BODE (4.65 
      +/- 1.93, 3.41 +/- 1.84), 6MWT (497 +/- 367 m, 572 +/- 397 m), UCSDSOBQ (68.3 +/- 21.1, 
      61.0 +/- 20.9), Pulmonary Disease Knowledge Test (75.9 +/- 12.4%, 85.9 +/- 11.1%), 
      short-acting bronchodilator (22.5 +/- 25.3, 12.8 +/- 15.6 inhalations per week) 
      (before, after PR; P < .001 for all comparisons). The RR emergency department 
      (ED) visits (0.71 +/- 1.44, 0.44 +/- 0.86; P = .04) and RR hospitalizations (0.41 +/- 
      0.73, 0.23 +/- 0.51; P = .03) (visits/patient/year; pre-PR, post-PR) decreased 
      following PR. RR ED visits and hospitalizations were the same for the PR and 
      referral groups prior to PR but declined post-PR (0.44 +/- 0.86, 0.78 +/- 1.36 ED 
      visits/patient/year; P = .05) and (0.23 +/- 0.51, 0.59 +/- 1.20 
      hospitalizations/patient/year; P = .01). Ninety-four percent of PR participants 
      achieved the minimal clinically important difference in at least 1 univariate 
      scale (Modified Medical Research Council, UCSDSOBQ, SGRQ, and 6MWT); 82%, 2 
      scales; 59%, 3 scales; and 24%, all 4 scales. CONCLUSIONS: Pulmonary 
      rehabilitation improves respiratory health in veterans with chronic obstructive 
      pulmonary disease and decreases RR health care utilization.
FAU - Major, Stephen
AU  - Major S
AD  - Pulmonary, Critical Care, and Sleep Medicine Division, Cincinnati Veterans 
      Affairs Medical Center (Drs Major and Panos), Pulmonary, Critical Care, and Sleep 
      Medicine Division, University of Cincinnati College of Medicine (Drs Major and 
      Panos), and Pulmonary Rehabilitation Program, Cincinnati Veterans Affairs Medical 
      Center (Ms Moreno, Mr Shelton, and Dr Panos), Cincinnati, Ohio.
FAU - Moreno, Marcella
AU  - Moreno M
FAU - Shelton, John
AU  - Shelton J
FAU - Panos, Ralph J
AU  - Panos RJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiopulm Rehabil Prev
JT  - Journal of cardiopulmonary rehabilitation and prevention
JID - 101291247
RN  - 0 (Bronchodilator Agents)
SB  - IM
MH  - Aged
MH  - Bronchodilator Agents/therapeutic use
MH  - Exercise Test/methods/statistics & numerical data
MH  - Exercise Therapy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Ohio
MH  - Patient Education as Topic/*methods
MH  - Program Evaluation/*methods
MH  - Pulmonary Disease, Chronic Obstructive/drug therapy/*rehabilitation
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Veterans/*statistics & numerical data
EDAT- 2014/08/29 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/08/29 06:00
PHST- 2014/08/29 06:00 [entrez]
PHST- 2014/08/29 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - 10.1097/HCR.0000000000000079 [doi]
PST - ppublish
SO  - J Cardiopulm Rehabil Prev. 2014 Nov-Dec;34(6):420-9. doi: 
      10.1097/HCR.0000000000000079.