Community-Based Pulmonary Rehabilitation Programs in Individuals With COPD

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Evidence-Based Practice

Background:

• Community-based pulmonary rehabilitation (PR) is an option for Chronic Obstructive Pulmonary Disease (COPD) patients.
• Existing literature lacks a comprehensive summary of community-based PR's effects.
• Investigating the health, physical, and respiratory impacts of community-based PR is crucial.

Purpose of the Study:

• To evaluate the health, physical, and respiratory effects of community-based PR in COPD patients.
• To compare community-based PR interventions against control groups.
• To synthesize evidence from randomized controlled trials on community-based PR for COPD.

Main Methods:

• Systematic literature search of PubMed and Embase databases up to May 2021.
• Inclusion of 10 randomized controlled trials (RCTs) involving 9,350 COPD participants.
• Meta-analysis using a random-effects model and assessment of risk of bias (RoB2) and certainty of evidence (GRADE).

Main Results:

• Community-based PR significantly improved St. George Respiratory Questionnaire (SGRQ) activity and total scores, and Chronic Respiratory Disease Questionnaire (CRDQ) dyspnea subscore.
• All included studies exhibited high risk or some concerns regarding bias.
• Meta-analyses demonstrated a very low certainty of evidence for all outcomes.

Conclusions:

• Community-based PR shows a trend towards superior health-related quality of life and symptom improvement compared to controls.
• Findings are inconsistent across different outcomes and supported by very low certainty evidence.
• Further high-quality research is required to establish definitive conclusions on the efficacy of community-based PR for COPD.