Benefits of completing pulmonary rehabilitation in patients with asthma

Abstract

Background: Asthma affects 30 million Americans and results in reduced productivity and quality of life. Pulmonary rehabilitation (PR) is known to improve physical conditioning and exercise performance in chronic lung diseases such as COPD, however, few studies have examined its benefits in patients with asthma. We aimed to determine the benefits of PR in this population as well as the predictors of completion of therapy. Methods: We performed a retrospective review of data from patients with a diagnosis of asthma who participated in PR at our institution from 1996 to 2013. Nine hundred and nineteen patients participated in the program of whom 75 were referred with a primary diagnosis of asthma. Patients underwent physiologic testing and their symptoms and quality of life were assessed using validated questionnaires. For patients who completed PR (n = 37), data obtained at the initial and exit visit was compared. Characteristics of completers were compared to non-completers to determine predictors of successful completion. Results: Individuals with asthma completing PR had improvement from baseline to exit visit in Six Minute Walk Distance (326 vs. 390 feet; p < 0.0001), decreased body mass index (33 vs. 32 kg/m²; p < 0.046), decreased Beck Depression Inventory scores (15 vs. 9; p < 0.0009), and increased Short Form-36 scores (345 vs. 445; p = 0.0005). In a multivariate logistic regression analysis, lower depression scores predicted completion (OR 1.08, 95% CI 1.02–1.15, p = 0.02). Conclusion: Patients with asthma who completed PR had improvement in physical function and emotional well-being. Depression is a risk factor for non-completion of PR. Further research is needed to determine which patients will benefit most from therapy.

• Management/control
• quality of life
• therapy

Declaration of interest

Jennifer Trevor, MD, deNay Kirkpatrick, DNP, Christopher Schumann and Jason Hitchcock have no conflicts of interest to disclose. Mark Dransfield, MD has served as a consultant for GSK, BI, and Ikaria. His institution has received research grant support from AHA, NHLBI, GSK and Forest and has received contracted support for enrolment in clinical trials from Aeris, BI, Boston Scientific, Centocor, GSK, Forest, Otsuka, Pearl, Pfizer, PneumRx, and PulmonX. Surya Bhatt, MD has received a grant from the American Heart Association. J Michael Wells, MD has received grants from Forest and GSK.