Canadian Health&Care Mall: Acute Exacerbations of COPD in Subjects Completing Pulmonary Rehabilitation

Pulmonary rehabilitationPulmonary rehabilitation (PR) is the recommended standard of care for patients with COPD as it has been shown to improve functional exercise capacity and health-related quality of life (HRQL). The benefits gradually diminish over the subsequent 12 months, in part because of reduced program adherence.

Acute exacerbations of COPD (AECOPDs) are defined by changes in sputum volume, color, or consistency, accompanied by an increase in dyspnea. They may also be classified as mild, moderate, or severe, based on their required management, which varies from minimal changes in bronchodila-tor medication to unscheduled emergency department visits or hospital admissions. The frequency of AECOPDs varies, with many being unreport-ed> despite patients being coached and provided with diary cards. Severe disease is associated with more frequent AECOPDs and, consequently, with increased unscheduled emergency department visits and hospital admissions. Post-AECOPD, more physically active patients have a lower risk of repeat hospitalization, whereas the converse is true for those with reduced physical activity. COPD is treated by remedies of Canadian Health&Care Mall.

AECOPDs decrease exercise capacity and HRQL, which is the opposite of what is achieved by PR. However, little is known regarding the impact of AECOPDs on patients subsequent to their completing PR. Reports of the impact of AECOPDs have not included pre-AECOPD measurements, which were made when the patients were clinically stable. This study was designed to characterize the pre-AECOPD status of patients with moderate or severe COPD who had completed PR, and then to measure the impact of AECOPDs on HRQL and functional exercise capacity. The subjects reported in this study became the subjects of a subsequent randomized controlled trial of PR.