Asthma control and health-related quality of life one year after inpatient pulmonary rehabilitation: the ProKAR Study

Abstract

Objectives: Although pulmonary rehabilitation (PR) is commonly used for asthmatics in many countries, so far there are no studies addressing the question of whether and for how long an improvement in asthma control (AC) is seen after rehabilitation. The ProKAR study (Prospektive Katamnesestudie Asthma-Rehabilitation) was performed to provide data concerning the short- and long-term impact of PR on AC. Methods: Two-hundred one adult patients with mild to severe persistent asthma were prospectively followed one year after completion of a 3-week PR program. AC, the primary outcome parameter, and health-related quality of life (HRQoL) were monitored using the Asthma Control Test (ACT) and St. George’s Respiratory Questionnaire (SGRQ) at initiation (T0) and end of the PR (T1) and 3, 6 and 12 months thereafter. Pulmonary function, physical fitness (6MWD) and asthmatic inflammation (FENO) were measured at T0 and T1. Results: The proportion of patients with well-controlled asthma (ACT score ≥20) increased from 33.2% to 67.3% after PR and was still at 51% after 12 months. Slight but statistically significant improvements in pulmonary functions and an increase in 6MWD of nearly 60 m were reported at T1. One year after discharge 55.8% of the patients still showed a clinically relevant improvement of at least 4 points in the total SGRQ score. Conclusions: The multidisciplinary inpatient PR program resulted in significant short and long-term improvement in AC and HRQoL in adult asthmatic patients.

• Asthma control test
• multidisciplinary/multimodal rehabilitation program
• physical ability or exercise tolerance (6MWD)
• pulmonary function
• short- and long-term asthma control

Acknowledgements

We greatly appreciate the input from the following people: the study nurses Mrs. C. Moser-Martinetz and Mrs I. Straberger, Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, for their patient assistance and backup, our IT-specialist Mr. A. Gierschmann for the technical support and the students Mrs I. Kehr and J. Höch who performed the digitalization of the data and the data- quality-management and Mr. D. Dettmer was responsible for the construction of the database and electronic collection-forms from the Institut für Allgemeinmedizin, Medizinische Hochschule Hannover and Mrs. P. Kay-Fedorov from the Institut für Virologie, Medizinische Hochschule Hannover for final draft revision of this paper.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.