title: Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial.
abstract: BACKGROUND
  Pulmonary rehabilitation seems to be an effective intervention in patients with chronic obstructive pulmonary disease. We undertook a randomised controlled trial to assess the effect of outpatient pulmonary rehabilitation on use of health care and patients' wellbeing over 1 year.
  
  
  METHODS
  200 patients with disabling chronic lung disease (the majority with chronic obstructive pulmonary disease) were randomly assigned a 6-week multidisciplinary rehabilitation programme (18 visits) or standard medical management. Use of health services was assessed from hospital and general-practice records. Analysis was by intention to treat.
  
  
  RESULTS
  There was no difference between the rehabilitation (n=99) and control (n=101) groups in the number of patients admitted to hospital (40 vs 41) but the number of days these patients spent in hospital differed significantly (mean 10.4 [SD 9.7] vs 21.0 [20.7], p=0.022). The rehabilitation group had more primary-care consultations at the general-practitioner's premises than did the control group (8.6 [6.8] vs 7.3 [8.3], p=0.033) but fewer primary-care home visits (1.5 [2.8] vs 2.8 [4.6], p=0.037). Compared with control, the rehabilitation group also showed greater improvements in walking ability and in general and disease-specific health status.
  
  
  CONCLUSIONS
  For patients chronically disabled by obstructive pulmonary disease, an intensive, multidisciplinary, outpatient programme of rehabilitation is an effective intervention, in the short term and the long term, that decreases use of health services.
authors.affiliation: Department of Medicine, University of Wales, College of Medicine, Llandough Hospital, Penarth, UK. griffithstl@cf.ac.uk
authors.forename: T L
authors.initials: TL
authors.lastname: Griffiths
authors.forename: M L
authors.initials: ML
authors.lastname: Burr
authors.forename: I A
authors.initials: IA
authors.lastname: Campbell
authors.forename: V
authors.initials: V
authors.lastname: Lewis-Jenkins
authors.forename: J
authors.initials: J
authors.lastname: Mullins
authors.forename: K
authors.initials: K
authors.lastname: Shiels
authors.forename: P J
authors.initials: PJ
authors.lastname: Turner-Lawlor
authors.forename: N
authors.initials: N
authors.lastname: Payne
authors.forename: R G
authors.initials: RG
authors.lastname: Newcombe
authors.forename: A A
authors.initials: AA
authors.lastname: Ionescu
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: J
authors.initials: J
authors.lastname: Tunbridge
authors.forename: A A
authors.initials: AA
authors.lastname: Lonescu
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D004045:Dietary Services; D005081:Exercise Therapy; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D009788:Occupational Therapy; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D011788:Quality of Life; D015656:Respiratory Mechanics