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Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales

Steiner, Michael C.; Lowe, Derek; Beckford,, Katy; Blakey, John; Bolton, Charlotte E.; Elkin, Sarah; Man, William D -C.; Roberts, C. Michael; Sewell, Louise; Walker, Paul; Singh, Sally J.

Authors

Michael C. Steiner

Derek Lowe

Katy Beckford,

John Blakey

Charlotte E. Bolton charlotte.bolton@nottingham.ac.uk

Sarah Elkin

William D -C. Man

C. Michael Roberts

Louise Sewell

Paul Walker

Sally J. Singh



Abstract

Background: Pulmonary rehabilitation (PR) improves exercise capacity and health status in patients with COPD, but many patients assessed for PR do not complete therapy. It is unknown whether socioeconomic deprivation associates with rates of completion of PR or the magnitude of clinical benefits bequeathed by PR.

Methods: PR services across England and Wales enrolled patients to the National PR audit in 2015. Deprivation was assessed using Index of Multiple Deprivation (IMD) derived from postcodes. Study outcomes were completion of therapy and change in measures of exercise performance and health status. Univariate and multivariate analyses investigated associations between IMD and these outcomes.

Results: 210 PR programmes enrolled 7413 patients. Compared with the general population, the PR sample lived in relatively deprived neighbourhoods. There was a statistically significant association between rates of completion of PR and quintile of deprivation (70% in the least and 50% in the most deprived quintiles). After baseline adjustments, the risk ratio (95% CI) for patients in the most deprived relative to the least deprived quintile was 0.79 (0.73 to 0.85), p

Journal Article Type Article
Publication Date Jun 1, 2017
Journal Thorax
Print ISSN 0040-6376
Electronic ISSN 1468-3296
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 72
Issue 6
APA6 Citation Steiner, M. C., Lowe, D., Beckford,, K., Blakey, J., Bolton, C. E., Elkin, S., …Singh, S. J. (2017). Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales. Thorax, 72(6), https://doi.org/10.1136/thoraxjnl-2016-209376
DOI https://doi.org/10.1136/thoraxjnl-2016-209376
Keywords COPD epidemiology, Pulmonary rehabilitation
Publisher URL http://thorax.bmj.com/content/72/6/530
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0





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