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Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial |
Farias CC, Resqueti V, Dias FAL, Borghi-Silva A, Arena R, Fregonezi GAF |
Brazilian Journal of Physical Therapy 2014 Mar-Apr;18(2):165-173 |
clinical trial |
7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: The current study evaluated the costs and benefits of a simple aerobic walking program for patients with chronic obstructive pulmonary disease (COPD). METHOD: This was a blinded randomized controlled clinical trial that recruited 72 patients diagnosed with COPD, 40 of whom were included in the study and divided into two groups (control group (CG) and pulmonary rehabilitation group (GPR)). We assessed pulmonary function, distance covered during the 6-minute walk test (6MWT), respiratory and peripheral muscle strength, health-related quality of life (HRQOL), body composition, and level of activities of daily living (ADLs) before and after an 8-week walking program. The financial costs were calculated according to the pricing table of the Brazilian Unified Health System (SUS). RESULTS: Only 34 of the 40 patients remained in the final sample; 16 in the CG and 18 in the GPR (FEV1: 50.9 +/- 14% predicted and FEV1: 56 +/- 0.5% predicted, respectively). The intervention group exhibited improvements in the 6MWT, sensation of dyspnea and fatigue, work performed, BODE index (p < 0.01), HRQOL, ADL level (p < 0.001), and lower limb strength (p < 0.05). The final mean cost per patient for the GPR was R$148.75 (about US$75.00) and no patient significantly exceeded this value. However, 2 patients in the CG did exceed this value, incurring a cost of R$ 689.15 (about US$345.00). CONCLUSION: Aerobic walking demonstrated significant clinical benefits in a cost-efficient manner in patients with COPD.
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