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Published ahead of print on December 27, 2002, doi:10.1164/rccm.200204-318OC
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American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 880-888, (2003)
© 2003 American Thoracic Society

Original Article

Maintenance after Pulmonary Rehabilitation in Chronic Lung Disease

A Randomized Trial

Andrew L. Ries, Robert M. Kaplan, Roseann Myers and Lela M. Prewitt

Division of Pulmonary and Critical Care Medicine and Department of Family and Preventive Medicine, University of California, San Diego, California

Correspondence and requests for reprints should be addressed to Andrew L. Ries, M.D., M.P.H., UCSD Medical Center #8377, 200 West Arbor Drive, San Diego, CA 92103-8377. E-mail: aries{at}ucsd.edu

Pulmonary rehabilitation is beneficial for patients with chronic lung disease. However, long-term maintenance has been difficult to achieve after short-term treatment. We evaluated a telephone-based maintenance program after pulmonary rehabilitation in 172 patients with chronic lung disease recruited from pulmonary rehabilitation graduates. Subjects were randomly assigned to a 12-month maintenance intervention with weekly telephone contacts and monthly supervised reinforcement sessions (n = 87) or standard care (n = 85) and followed for 24 months. Except for a slight imbalance between sexes, experimental and control groups were equivalent at baseline and showed similar improvements after rehabilitation. During the 12-month intervention, exercise tolerance (maximum treadmill workload and 6-minute walk distance) and overall health status ratings were better maintained in the experimental group together with a reduction in hospital days. There were no group differences for other measures of pulmonary function, dyspnea, self-efficacy, generic and disease-specific quality of life, and health care use. By 24 months, there were no significant group differences. Patients returned to levels close to but above prerehabilitation measures. We conclude that a maintenance program of weekly telephone calls and monthly supervised sessions produced only modest improvements in the maintenance of benefits after pulmonary rehabilitation.

Key Words: patient compliance • behavior therapy • exercise therapy • health status • quality of life




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