TY - JOUR
T1 - A Specific Home Care Program Improves the Survival of Patients With Chronic Obstructive Pulmonary Disease Receiving Long Term Oxygen Therapy
AU - Rizzi, Maurizio
AU - Grassi, Mario
AU - Pecis, Marica
AU - Andreoli, Arnaldo
AU - Taurino, Anna Eugenia
AU - Sergi, Margherita
AU - Fanfulla, Francesco
PY - 2009/3
Y1 - 2009/3
N2 - Rizzi M, Grassi M, Pecis M, Andreoli A, Taurino AE, Sergi M, Fanfulla F. A specific home care program improves the survival of patients with chronic obstructive pulmonary disease receiving long term oxygen therapy. Objectives: To analyze the influence of a home care (HC) program on outcomes of patients with chronic obstructive pulmonary disease (COPD) receiving long-term oxygen therapy (LTOT) in comparison with outcomes of patients receiving standard care (SC). Design: A 10-year follow-up study with 2 parallel cohorts (HC vs SC). Setting: University hospital. Participants: One hundred and eight patients in the HC program and 109 patients managed conventionally. Interventions: The HC program consisted of outpatient clinical and functional evaluations every 6 months, and domiciliary assessments by a specific team including a pneumologist, a respiratory nurse, and a rehabilitation therapist every 2 to 3 months or more, as needed. Main Outcome Measures: Mortality; exacerbation, hospital and intensive care unit admission rate. Results: One hundred and eight patients entered the HC program and 109 patients were managed conventionally. The 2 groups of patients did not differ for age, sex, body mass index, COPD severity or comorbid conditions. The overall mortality during the follow-up was 63% and the median survival was 96±38 months. The survival curves for HC and SC patients were statistically significantly different (log-rank, -16.04; P=.0001). In the Cox proportional hazards model, inclusion in the HC program was associated with an increased survival rate, whereas comorbid conditions and requirement of mechanical ventilation during the follow-up were associated with a decreased survival rate. During the entire follow-up, HC patients had a lower number of exacerbations/year than SC patients. Conclusions: A disease-oriented HC program is effective in reducing mortality and hospital admissions in COPD patients requiring LTOT.
AB - Rizzi M, Grassi M, Pecis M, Andreoli A, Taurino AE, Sergi M, Fanfulla F. A specific home care program improves the survival of patients with chronic obstructive pulmonary disease receiving long term oxygen therapy. Objectives: To analyze the influence of a home care (HC) program on outcomes of patients with chronic obstructive pulmonary disease (COPD) receiving long-term oxygen therapy (LTOT) in comparison with outcomes of patients receiving standard care (SC). Design: A 10-year follow-up study with 2 parallel cohorts (HC vs SC). Setting: University hospital. Participants: One hundred and eight patients in the HC program and 109 patients managed conventionally. Interventions: The HC program consisted of outpatient clinical and functional evaluations every 6 months, and domiciliary assessments by a specific team including a pneumologist, a respiratory nurse, and a rehabilitation therapist every 2 to 3 months or more, as needed. Main Outcome Measures: Mortality; exacerbation, hospital and intensive care unit admission rate. Results: One hundred and eight patients entered the HC program and 109 patients were managed conventionally. The 2 groups of patients did not differ for age, sex, body mass index, COPD severity or comorbid conditions. The overall mortality during the follow-up was 63% and the median survival was 96±38 months. The survival curves for HC and SC patients were statistically significantly different (log-rank, -16.04; P=.0001). In the Cox proportional hazards model, inclusion in the HC program was associated with an increased survival rate, whereas comorbid conditions and requirement of mechanical ventilation during the follow-up were associated with a decreased survival rate. During the entire follow-up, HC patients had a lower number of exacerbations/year than SC patients. Conclusions: A disease-oriented HC program is effective in reducing mortality and hospital admissions in COPD patients requiring LTOT.
KW - COPD
KW - Home care
KW - Mortality
KW - Rehabilitation
KW - Respiratory failure
KW - Survival
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U2 - 10.1016/j.apmr.2008.08.223
DO - 10.1016/j.apmr.2008.08.223
M3 - Article
C2 - 19254602
AN - SCOPUS:61349101865
VL - 90
SP - 395
EP - 401
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 3
ER -