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Pulmonary rehabilitation in group 3 pulmonary hypertension: An evaluation of clinical outcomes, adherence and safety

Crawfurd, L; Marino, P; Osman, L; Hogg, L; McDonnell, L; Shannon, H; (2019) Pulmonary rehabilitation in group 3 pulmonary hypertension: An evaluation of clinical outcomes, adherence and safety. European Respiratory Journal , 54 (63) , Article PA522. 10.1183/13993003.congress-2019.PA522. Green open access

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Abstract

Background: Pulmonary Rehabilitation (PR) may improve exercise tolerance and health status in patients with pulmonary hypertension groups 1 and 4 (Morris, N. et al. Cochrane database, 2017). Little is known about the effectiveness, safety or feasibility of PR in patients with group 3 pulmonary hypertension (that which is associated with lung disease), who access PR due to their underlying respiratory pathology. Aims: To describe clinical outcomes, adherence and safety in patients with group 3 pulmonary hypertension attending a standard United Kingdom-based PR programme. Method: A retrospective casenote review was conducted for patients with group 3 pulmonary hypertension attending PR over a 3-year period (2016-2019). Data included pre- and post-PR six-minute walk distance (6MWD), Medical Research Council breathlessness scale (MRC), COPD assessment test (CAT), patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7). Adherence and adverse events were collected. Results: Thirty-one patients with group 3 pulmonary hypertension were enrolled in PR. There was a significant improvement in 6MWD (median change 30m; 95%CI 5, 70m p=0.023;) and MRC (median change -1.0; 95%CI -1.0, -0.5; p=0.005) following PR but no change in CAT, PHQ-9 or GAD-7. PR completion rate was 65%. Low to medium risk adverse events did occur, most commonly, oxygen desaturation below 80%. Conclusion: In patients with group 3 pulmonary hypertension, PR is feasible and low-risk. Significant improvements in 6MWD were achieved, although the impact on health status was less clear. The occurrence of adverse events suggests the need for extra monitoring in this patient group.

Type: Article
Title: Pulmonary rehabilitation in group 3 pulmonary hypertension: An evaluation of clinical outcomes, adherence and safety
Event: ERS (European Respiratory Society) 2019
Location: Madrid
Dates: 28 September 2019 - 02 October 2019
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/13993003.congress-2019.PA522
Publisher version: https://doi.org/10.1183/13993003.congress-2019.PA5...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10080962
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