Patients recovering from exacerbations of COPD with and without hospitalization need: could ICF score be an additional pulmonary rehabilitation outcome?

Abstract

AbstractObjective To compare disability changes measured with the Respiratory ICF Maugeri core set on COPD patients, recovering from acute exacerbation with and without hospitalization, submitted to pulmonary rehabilitation (PR).Materials and methods All COPD inpatients admitted for rehabilitation in 9 Respiratory Units (January–August 2019) were considered eligible. 2066 patients were included (540 discharged from an acute Hospital = Hospital group and 1526 coming from their home = Home group). Healthcare professionals filled, in a digitalized chart, the Respiratory ICF Maugeri core set (26 items), assessing ICF categories at admission and discharge.Results The baseline distribution of the more severe ICF qualifiers was higher in the Hospital group (p < .001) when compared to the Home group. After rehabilitation, all patients -irrespective of hospitalization need- statistically decreased the rate of the higher ICF qualifiers (p < .0001). Hospital group improved more both the rate of qualifiers ≥2 [Δ: −21.32 (22.41) vs −15.48 (17.32), p < .001] and the rate of qualifiers 0–1 [Δ: + 18.38 (24.67) vs 13.25 (19.13), p < .001] than Home group.Conclusions Disability measured with the “Respiratory ICF Maugeri core set” after PR improves in COPD patients recovering from acute exacerbation irrespective of hospitalization need. Its use an additional outcome remains to be further elucidated.KEY MESSAGESRoutine implementation of an ICF set for chronic respiratory diseases can enhance a patient-centered approach in rehabilitation for different severity conditions.Pulmonary rehabilitation (PR) seems to improve global disability measured with the Respiratory ICF Maugeri core set in COPD patients recovering from acute exacerbation irrespective of hospitalization need, suggesting the use of ICF set as additional PR outcome.The description, through the ICF language, of rehabilitative needs of patients, coming "from-Home" and "from-Hospital" settings, could help staff and instrument organization.

Keywords

• ICF
• chronicity
• respiratory disease
• rehabilitation
• implementation