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Category: Volume 10 Issue 05 May 2022
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Title: Assessment of Quality of life in Home versus Hospital Based Pulmonary Rehabilitation in COPD Patients: A Comparative Study

Authors: Dr N. Meenakshi, Dr N. Lokeswara Reddy, Dr Aruna Shanmuganathan, Dr Ragulan.R, Dr Muthukumaran.L, Dr Nisha Ganga

 DOI: https://dx.doi.org/10.18535/jmscr/v10i5.10

Abstract

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is characterized by limitation in airflow which is an incompletely reversible and is a 3rdleading cause of death worldwide 2020. Pulmonary rehabilitation has been shown to be effective therapeutic strategy to improve quality of life, Health status and exercise intolerance. Evidence indicates that benefits of home rehabilitation are on par with hospital based in western studies, with limited data on Indian population. Hence the current study has undertaken to correlate home PR with hospital PR under by using St. George Respiratory Questionnaire and BODE index

Materials and Methods: Prospective, randomized controlled study with 112 subjects were randomized to two groups to receive hospital or home pulmonary rehabilitation and were followed up for 3months (every week in hospital group and once in every 2weeks in home group). Anthropometric variables assessed by body-mass index, airflow limitation was assessed by spirometry, degree of dyspnea was assessed by Modified Medical Research Council (mMRC) scale and exercise tolerance was assessed by six-minute walk test (6MWT). Statistical analysis done by SPSS software IBMS version 22.

Results: 56 subjects were allocated in each group with mean age group 61.43±7.26 and64.04 ±8.56years in hospital and home group respectively and both study groups were matched in age, anthropometry, smoking status, and comorbidities. The mean baseline and post rehabilitation BODE index in Hospital group are 5.6±2and4.5±2 respectively with a mean difference of 1.5±1.3 which is statistically significant. The mean baseline and post rehabilitation BODE index in home-based PR group are 4.6±2 and 3.3±2 respectively, with a mean difference of 1.3±0.6 in home group which is statistically significant. The mean total score (SGRQ) at baseline was 45.87 ± 3.53 and 45.64 ± 2.97 in Hospital and Home group respectively. The mean total score at12th week was 35.89 ± 6.4 and 38.58 ± 8.74 in Hospital and Home group respectively. The difference in scores of SGRQ at baseline and post rehabilitation between home and hospital groups was statistically not significant (P value >0.05), thus shows similar improvement in both study groups. However, attrition rate is more in Home-based group compared to Hospital-based group.

Conclusion: The outcomes of PR are between Home and Hospital Groups are comparable. The attrition rate is more in home-based PR group with lack of family support being important cause to poor adherence to PR.  All COPD patients should be encouraged to utilize the healthcare facilities to undergo pulmonary Rehabilitation for improving their quality of life.

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Corresponding Author

Dr Lokeswara Reddy. N

Post graduate Resident, Department of Respiratory Medicine, Chettinad Hospital & Research Institute

(Kelambakkam, Kancheepuram District, Tamil Nadu, India)