Is pulmonary rehabilitation effective when the patient is provided care by a single healthcare professional: concept of a care manager.

<bold>Objective:</bold> We developed a home-based PR programme in which the patient and his/her caregiver are provided care by a single person, a <italic>care manager</italic>, throughout the entire intervention. We aimed to compare the effectiveness of this programme according to the initial training of the <italic>care managers</italic>. <bold>Methods:</bold> PR team was composed of a respiratory physician, physiotherapists, nurses, kinesiologists, a dietician and a sociomedical beautician. PR consisted of one supervised home session per week during 8 weeks. Quality of life (CAT and VSRQ), exercise tolerance (6-min stepper test, 6MST) and anxiety and depressive symptoms (HAD) were assessed. Patients were retrospectively divided into 4 groups (Gr) according to the initial training of the care manager (Table 1). <bold>Results:</bold> 2599 patients were included in the retrospective analysis (COPD: 40.9%; asthma : 9.5%; IPF: 8.9%; f-NSIP: 9.5%; others: 40.7%) (Table 1). All the outcomes were improved by PR for the 4 groups (p<0.01). The evolution of the study assessments thorough time was not different between groups (CAT, p=0.196; VSRQ, p=0.077; anxiety, p=0.805; depression, p=0.805; 6MST, p=0.739) <table-wrap><object-id>erj;64/suppl_68/PA3189/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td> Gr1 (484) </td><td>Gr2 (1049)</td><td>Gr3(846)</td><td>Gr4(220)</td></tr><tr><td>Age, years</td><td>64.3±9.4</td><td>64.8 ± 9.8</td><td>63.2±10.2</td><td>64.1±10.3</td></tr><tr><td>FEV1, %</td><td>51.1±25.0</td><td>50.6±20.5</td><td>53.2±21.7</td><td>50.9±20.8</td></tr><tr><td>CAT</td><td>21.6±7.8</td><td>20.9±8.0</td><td>21.7±7.3</td><td>20.0±8.0</td></tr><tr><td>Anxiety</td><td>8.9±4.6</td><td>9.1±4.6</td><td>9.2±4.5</td><td>9.3±4.3</td></tr><tr><td>Depression</td><td>7.3±4.2</td><td>7.5±4.1</td><td>7.6±4.1</td><td>7.7±4.2</td></tr><tr><td>6MST, strokes</td><td>351±168</td><td>335±152</td><td>385±178 a, b</td><td>367±156</td></tr></tbody></table><table-wrap-foot> p<0.05 ^avs Gr1, ^bvs Gr2 </table-wrap-foot></table-wrap> <bold>Conclusion:</bold> These results suggested that a personalized home-based PR programme offered by a trained care manager, lead to similar benefits irrespective of his or her initial training.