School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia (Mr Noteboom, Drs Jenkins, Maiorana, and Hill, and Ms Ng); Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia (Mr Noteboom); Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Perth, Western Australia, Australia (Mr Noteboom, Drs Jenkins and Hill, and Mss Cecins and Ng); Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia (Dr Jenkins and Ms Cecins); Cardiac Transplant and Advanced Heart Failure Service, Royal Perth Hospital, Perth, Western Australia, Australia (Dr Maiorana); and Community Physiotherapy Services, North Metropolitan Area Health Service, Perth, Western Australia, Australia (Ms Cecins).
J Cardiopulm Rehabil Prev. 2014 Jan-Feb;34(1):75-9. doi: 10.1097/HCR.0000000000000036.
Chronic obstructive pulmonary disease (COPD) is characterized by concomitant systemic manifestations and comorbidities such as cardiovascular disease. Little data exist on the prevalence of comorbidities and medication burden in people with COPD attending pulmonary rehabilitation (PR) programs in Australia. This study aimed to determine the prevalence of comorbidities and describe the type and number of medications reported in a sample of patients with COPD referred to PR.
A retrospective audit was conducted on patients referred to PR over a 1-year period. Data were collected on patient demographics, disease severity, comorbidities, and medications by review of patient notes, physician referral, and self-reported medication use.
Data were available on 70 patients (forced expiratory volume in 1 second = 37.5 [26.0] % predicted). Ninety-six percent of patients had at least 1 comorbidity, and 29% had 5 or more. The most common comorbidities were associated with cardiovascular disease (64% of patients). Almost half of the sample was overweight or obese (49%). Prescription medication use was high, with 57% using between 4 and 7 medications, and 29% using 8 or more.
Patients with COPD attending PR in Australia have high rates of comorbidity. The number of medications prescribed for these individuals is similar to that seen in other chronic disease states such as chronic heart failure. Pulmonary rehabilitation presents opportunities for clinicians to educate patients on self-management strategies for multiple comorbidities, review medication usage, and discuss strategies aimed at optimizing adherence with medication regimes.
慢性阻塞性肺疾病（COPD）的特征是同时存在全身表现和合并症，如心血管疾病。在澳大利亚参加肺康复（PR）计划的 COPD 患者中，关于合并症的患病率和药物负担的数据很少。本研究旨在确定合并症的患病率，并描述向 PR 转诊的患者样本中报告的合并症的类型和数量。
对 1 年内转诊至 PR 的患者进行回顾性审核。通过回顾患者病历、医生转诊和自我报告的药物使用情况，收集患者人口统计学、疾病严重程度、合并症和药物的数据。
70 名患者（第 1 秒用力呼气量 = 预测值的 37.5[26.0]%）的数据可用。96%的患者至少有 1 种合并症，29%的患者有 5 种或更多合并症。最常见的合并症与心血管疾病有关（64%的患者）。几乎一半的样本超重或肥胖（49%）。处方药物使用率很高，57%的患者使用 4-7 种药物，29%的患者使用 8 种或更多药物。
在澳大利亚参加 PR 的 COPD 患者合并症的发生率很高。为这些患者开的药物数量与慢性心力衰竭等其他慢性疾病相似。肺康复为临床医生提供了机会，可对多种合并症的自我管理策略进行教育，审查药物使用情况，并讨论旨在优化药物治疗依从性的策略。
