Evaluation of a maintenance 3-Year follow-up pulmonary rehabilitation program

Objective: A multi-centre 3-year follow-up study was carried out to assess the efficacy of a home-based supervised maintenance program of Pulmonary Rehabilitation (PR) to preserve the benefits obtained during a primary PR period, in comparison with usual care. Methods: We included 143 COPD patients:mean age 64(8)yrs; 127/16 m/f; mean FEV 1 34(9)%; mean BODE 4.7 (1.58). After completion of a 8-wk PR, patients were randomized to control group (CG) or treatment group (TG), who attended outpatient sessions every two weeks and received a telephone call every other week. Variables (6WT, BODE, HRQoL, exacerbations, hospital admissions) were analyzed at points 2, 12, 24 and 36 months. Results: 64 out of 143 completed the follow-up period, without any difference in the dropout rate between groups. Patients who finished the study showed better results in 6WT and HRQoL at baseline: 6WT:406(5) vs 348(98)m, p=0,002; CRQd 4.66 vs 3.88 points , p=0.001; CRQf 4.43 vs 3.84, p=0,008; CDQef 4.91 vs 4.37, p=0.009. Significant differences along the maintenance program were only observed in the 6WT at 12-m, which decreased less in the TG [-2.8(56) m; CG:-39,3(72) m; p=0.018] without further significant differences at 24 and 36-m points. After 3-year follow-up, initial improvements in the main variables were not maintained in either group. Conclusions: Patients with better conditions at baseline of PR showed a greater adherence to our maintenance program. The maintenance PR program implemented in this population of severe COPD patients was not able to preserve initial benefits compared to usual care, although is responsible for a slower decrease in the functional walking capacity during the first year of follow-up.