Chronic obstructive pulmonary disease: rehabilitation program with continuation on an outpatient basis

A total of 187 patients with chronic obstructive pulmonary disease (COPD) were treated in a rehabilitation program, initially as inpatients and then scheduled to continue 6 months or more in an outpatient clinic. The mean age was 61 (range, 28-76 years). Changes shown by participants in the outpatient program were compared to those shown by the nonparticipants. For both groups, the mortality rates were similar to published figures, and were strongly related to the levels of forced expiratory volume/sec (FEV 1.0). The FEV 1.0 declined significantly within one year in both groups. Psychologic test scores were unchanged. There was a sharp increase in unemployment. Although rehabilitative therapy must be continued, high priority should be given to early detection of COPD in patients who have airway obstruction but are otherwise asymptomatic. Possibly, at that stage, the elimination of cigarette smoking may slow the process.