A Specific Home Care Program Improves the Survival of Patients With Chronic Obstructive Pulmonary Disease Receiving Long Term Oxygen Therapy

Maurizio Rizzi, Mario Grassi, Marica Pecis, Arnaldo Andreoli, Anna Eugenia Taurino, Margherita Sergi, Francesco Fanfulla

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume90
Issue number3
DOIs
Publication statusPublished - Mar 2009

Keywords

  • COPD
  • Home care
  • Mortality
  • Rehabilitation
  • Respiratory failure
  • Survival

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

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