Abstract
Background: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD. Methods: A total of 142 patients with severe COPD (FEV1 < 50%) were enrolled; 120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group). Number of acute exacerbations COPD (AECOPD) after 1 month and 3 months were the primary outcomes. Secondary outcomes were changes in respiratory function parameters (FVC, FEV1, TLC, RV), arterial blood gases, dyspnea and health status assessment scales (Modified Medical Research Council (MMRC), Breathlessness, Cough and Sputum scale (BCSS) and COPD Assessment Test (CAT). The time of daily use of the T-PEP was registered as well as its acceptance using a Likert scale. Results: Ninety-nine patients completed the study. Both the groups who used T-PEP showed a statistical lower number of AECOPD after 1 month and 3 months (P < 0.01). Some respiratory functional parameters improved in the two groups treated with T-PEP (FVC, FEV1, RV) (P < 0.02) and dyspnea and health status assessment scales (MMRC, BCSS, CAT) (P < 0.04; P < 0.01; P < 0.009). The time of daily using was similar in the two T-PEP groups. Patients treated at home showed a greater acceptance than those treated at hospital (Likert scale 4.7 vs. 5.9) (P < 0.01). Conclusions: Patients treated with T-PEP showed a lower number of AECOPD. T-PEP improves functional respiratory parameters and improves dyspnea and health status assessment scales. No adherence difference in hospital and home treatment was found. Patients preferred home treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 2895-2902 |
| Number of pages | 8 |
| Journal | Journal of Thoracic Disease |
| Volume | 8 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2016 |
Fingerprint
Keywords
- Home administering
- Hospital administering
- Severe chronic obstructive pulmonary disease
- Temporary expiratory pressure (T-PEP)
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Effectiveness of temporary positive expiratory pressure (T-PEP) at home and at hospital in patients with severe chronic obstructive pulmonary disease. / Mascardi, Valentina; Grecchi, Bruna; Barlascini, Cornelius; Banfi, Paolo; Nicolini, Antonello.
In: Journal of Thoracic Disease, Vol. 8, No. 10, 2016, p. 2895-2902.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effectiveness of temporary positive expiratory pressure (T-PEP) at home and at hospital in patients with severe chronic obstructive pulmonary disease
AU - Mascardi, Valentina
AU - Grecchi, Bruna
AU - Barlascini, Cornelius
AU - Banfi, Paolo
AU - Nicolini, Antonello
PY - 2016
Y1 - 2016
N2 - Background: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD. Methods: A total of 142 patients with severe COPD (FEV1 < 50%) were enrolled; 120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group). Number of acute exacerbations COPD (AECOPD) after 1 month and 3 months were the primary outcomes. Secondary outcomes were changes in respiratory function parameters (FVC, FEV1, TLC, RV), arterial blood gases, dyspnea and health status assessment scales (Modified Medical Research Council (MMRC), Breathlessness, Cough and Sputum scale (BCSS) and COPD Assessment Test (CAT). The time of daily use of the T-PEP was registered as well as its acceptance using a Likert scale. Results: Ninety-nine patients completed the study. Both the groups who used T-PEP showed a statistical lower number of AECOPD after 1 month and 3 months (P < 0.01). Some respiratory functional parameters improved in the two groups treated with T-PEP (FVC, FEV1, RV) (P < 0.02) and dyspnea and health status assessment scales (MMRC, BCSS, CAT) (P < 0.04; P < 0.01; P < 0.009). The time of daily using was similar in the two T-PEP groups. Patients treated at home showed a greater acceptance than those treated at hospital (Likert scale 4.7 vs. 5.9) (P < 0.01). Conclusions: Patients treated with T-PEP showed a lower number of AECOPD. T-PEP improves functional respiratory parameters and improves dyspnea and health status assessment scales. No adherence difference in hospital and home treatment was found. Patients preferred home treatment.
AB - Background: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD. Methods: A total of 142 patients with severe COPD (FEV1 < 50%) were enrolled; 120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group). Number of acute exacerbations COPD (AECOPD) after 1 month and 3 months were the primary outcomes. Secondary outcomes were changes in respiratory function parameters (FVC, FEV1, TLC, RV), arterial blood gases, dyspnea and health status assessment scales (Modified Medical Research Council (MMRC), Breathlessness, Cough and Sputum scale (BCSS) and COPD Assessment Test (CAT). The time of daily use of the T-PEP was registered as well as its acceptance using a Likert scale. Results: Ninety-nine patients completed the study. Both the groups who used T-PEP showed a statistical lower number of AECOPD after 1 month and 3 months (P < 0.01). Some respiratory functional parameters improved in the two groups treated with T-PEP (FVC, FEV1, RV) (P < 0.02) and dyspnea and health status assessment scales (MMRC, BCSS, CAT) (P < 0.04; P < 0.01; P < 0.009). The time of daily using was similar in the two T-PEP groups. Patients treated at home showed a greater acceptance than those treated at hospital (Likert scale 4.7 vs. 5.9) (P < 0.01). Conclusions: Patients treated with T-PEP showed a lower number of AECOPD. T-PEP improves functional respiratory parameters and improves dyspnea and health status assessment scales. No adherence difference in hospital and home treatment was found. Patients preferred home treatment.
KW - Home administering
KW - Hospital administering
KW - Severe chronic obstructive pulmonary disease
KW - Temporary expiratory pressure (T-PEP)
UR - http://www.scopus.com/inward/record.url?scp=84995449865&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84995449865&partnerID=8YFLogxK
U2 - 10.21037/jtd.2016.10.69
DO - 10.21037/jtd.2016.10.69
M3 - Article
AN - SCOPUS:84995449865
VL - 8
SP - 2895
EP - 2902
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
IS - 10
ER -