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Community pulmonary rehab just as good as in hospital

By Lilian Anekwe

Pulmonary rehabilitation delivered in a community setting is as effective as that given in hospital, a Department of Health-funded analysis has concluded

A randomised controlled trial of community and hospital pulmonary rehabilitation found rehab delivered in a community setting ‘has similar efficacy to that produced in a more traditional hospital-based setting.'

240 patients with COPD were given with hospital or community pulmonary rehabilitation, followed by either telephone or standard care, and researchers measured their improvement on the endurance shuttle walking test (ESWT) immediately after rehab and then after 6, 12 and 18 months.

Post rehabilitation, patients in the hospital rehab group could walk 283 m further, and patients in the community rehabilitation group 216m further, a statistically insignificant difference.

There was also no evidence of a difference between groups after 6, 12 or 18 months post rehabilitation. The average difference in ESWT between the hospital and community rehabilitation groups was 1.5 m, and 56.9 m between the telephone and no-telephone groups. A health economic analysis also found no difference in cost-effectiveness.

Dr Roderick Lawson, lead investigator and consultant respiratory physician at the Royal Hallamshire Hospital concluded: ‘The choice of model will depend on local factors of convenience, existing availability of resources and incremental costs.'

Health Technology Assessment 2101 Feb;14(6):1-164

Community pulmonary rehab just as good as in hospital, according to a new study