Highlights
- •Effects of pulmonary rehabilitation in COPD under inhaled triple therapy (TT) as compared to individuals not using TT are unclear.
- •Significant post program improvements in 6MWT were found in both groups.
- •Effect size and % of individuals reaching the MCID of 6MWT were higher in TT group.
- •Independent predictors for MCID of 6MWT were hospital provenience, TT use, and high eosinophils count.
Abstract
Background and aim
Real-life studies report discordant prescribing of inhaled triple therapy (TT) among
individuals with COPD. Guidelines recommend pulmonary rehabilitation (PR) for persistent
breathlessness and/or exercise limitation. This real-life study aimed to assess the
effects of in-patient PR in individuals under TT as compared to other inhaled therapies
(no TT).
Methods
Multicentric, retrospective analysis of data from individuals admitted to in-hospital
PR. Baseline characteristics were recorded and lung function was assessed. Outcome
measures were: 6-min walking test (6MWT: primary outcome), Medical Research Council
(MRC) scale for dyspnoea, and COPD assessment test (CAT).
Results
Data of pre and post program 6MWT of 1139 individuals were available. Pulmonary rehabilitation
resulted in significant improvement in 6MWT in both groups, however, the effect size
(by 54.3 ± 69.7 vs 42.5 ± 64.2 m, p = 0.004) and proportion of individuals reaching
the minimal clinically important difference (MCID) of 6MWT (64.2%, vs 54.3%, p = 0.001)
were higher in TT group. Both groups significantly improved also the other outcome
measures. The significant independent predictors of reaching the MCID of 6MWT were
hospital provenience, TT use, and high eosinophils count.
Conclusion
Pulmonary rehabilitation results in significant benefits in individuals with COPD
irrespective of the use of TT. However, individuals under TT report larger benefits
in exercise tolerance than those under no TT.
Keywords
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Article info
Publication history
Published online: August 27, 2022
Accepted:
August 22,
2022
Received in revised form:
August 18,
2022
Received:
June 28,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
