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

Michele Vitacca; Laura Comini; Anna Giardini; Adriana Olivares; Giacomo Corica; Mara Paneroni

doi:10.1080/07853890.2021.1900592

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

Ann Med. 2021 Dec;53(1):470-477. doi: 10.1080/07853890.2021.1900592.

Authors

Michele Vitacca¹, Laura Comini², Anna Giardini³, Adriana Olivares², Giacomo Corica⁴, Mara Paneroni¹

Affiliations

¹ Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
² Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, Brescia, Italy.
³ Istituti Clinici Scientifici Maugeri IRCCS, IT Department, Pavia, Italy.
⁴ Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate of the Institute of Lumezzane, Brescia, Italy.

Abstract

Objective: 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; implementation; rehabilitation; respiratory disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Disability Evaluation
Disabled Persons / rehabilitation*
Female
Hospitalization
Humans
International Classification of Functioning, Disability and Health*
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / psychology
Pulmonary Disease, Chronic Obstructive / rehabilitation*
Recovery of Function
Retrospective Studies
Treatment Outcome

Grants and funding

This work was supported by the “Ricerca Corrente” Funding scheme of the Ministry of Health, Italy.