To Evaluate the Efficacy of a Half Day Outpatient Pulmonary Rehabilitation Program in Haven of Hope Hospital

Abstract Description

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Authors (including presenting author) :

Wong WY(1), Sze SS(1), Leung SY(2), Chan TM(3), Chan OY(1), Chan KK(1), Shing KK(1), Yip CW(1), Wong TC(1), Chan KS(1)

Affiliation :

(1)Department of Medicine, (2)Department of Physiotherapy, (3)Department of Occupational Therapy, Haven of Hope Hospital

Introduction :

There is strong evidence that Pulmonary Rehabilitation Program (PRP) can improve symptoms, exercise capacity and quality of life in patients with chronic lung disease. PRP can also promote self-management and break the inactivity cycle. To improve the efficiency of the service delivery, our PRP was changed from full day to half day program since March 2017. The frequency (3 times per week) and duration (6 weeks) of the PR remained unchanged.

Objectives :

To evaluate the effectiveness of half-day PRP and to compare the outcome with full-day program

Methodology :

1. Data on pre- and post- PRP outcome parameters were collected which included exercise capacity (6- minute walk test (6MWT), endurance test), Quality of life (Chronic Respiratory Disease Questionnaire (CRQ) – Dyspnea(D), Fatigue(F), Emotion(E) and Mastery(M)) and self-efficacy score. Within-group differences were evaluated by Paired-t test / Wilcoxon Signed Rank test. 2. Outcomes were compared between half-day and full-day program. Between-group differences were analyzed by Independent-t test / Mann-Whitney U test.

Result & Outcome :

From 11 May 2017 to 10 May 2018, 104 patients were recruited for the half-day program and 94 patients completed the program with the completion rate of 90.4%. Majority of patients were male (91.5%) and with diagnosis of COPD (86.2%). The mean age was 71.5 +/- 10.1 year old. There was significant improvement of half-day PRP in 6MWT (pre 342.2 +/- 117.1m vs post 395.3 +/- 116.7m, p< 0.001), endurance test (pre 8.1 +/- 6.6 min vs post 21.5 +/- 22.2min, p< 0.001), self-efficacy score (pre 6.3 +/- 1.9 vs post 7.3 +/- 1.9, p< 0.001) and CRQ. Compared to full-day program, the improvement in CRQ was significant higher in the half-day program (change in CRQ-D: half-day 1.17 +/- 0.76 vs full-day 0.73 +/- 0.64, p< 0.001, change in CRQ-F: half-day 1.01 +/- 0.66 vs 0.60 +/- 0.96, p< 0.001). There were no significant difference in 6MWT and endurance test between half-day and full-day program. Conclusions: Half-day PRP was effective and showed improvement in all rehabilitation outcome parameters. Compared to full-day PRP, half-day program could achieve a comparable improvement in exercise capacity and it also could attain better quality of life.