This retrospective study demonstrated that pulmonary rehabilitation improves cough-related quality of life (CR-QoL) in people with chronic respiratory diseases (CRDs). Baseline severity of CR-QoL impairment and disease impact were strong predictors of positive response.
The study included 135 patients with chronic respiratory diseases (CRDs), of whom 39% were female, 61% had chronic obstructive pulmonary disease (COPD), and the mean age was 68±10 years. The mean forced expiratory volume in one second (FEV1) was 62.6±23.0% predicted. CR-QoL was assessed using the Leicester Cough Questionnaire (LCQ), and disease impact was measured using the COPD Assessment Test (CAT). Cut-off values of <17.05 for LCQ total score and ≥10 for CAT were used to define low CR-QoL and moderate or more significant disease impact. Responders were defined as achieving a minimal clinically important difference (MCID) of ≥1.3 in LCQ total score. Pre- and post-pulmonary rehabilitation comparisons were made using the t-test, Wilcoxon, or McNemar tests. Group comparisons used independent t-test, Mann–Whitney U-test, or Fisher’s exact test. Logistic regression was performed to identify factors associated with achieving MCID.
Following pulmonary rehabilitation, statistically significant improvements were observed in all LCQ domains and CAT scores. 31% of participants (36% females, mean age 66±10 years, 62% with COPD, FEV1 % predicted 60.0±22.3%) achieved the MCID threshold and were classified as responders. This group significantly improved LCQ and CAT scores significantly more than nonresponders. Logistic regression analysis indicated that individuals with low CR-QoL at baseline were 11 times more likely to respond to pulmonary rehabilitation (OR 11.0). Those with medium to high baseline disease impact were 4 times more likely to show clinically meaningful improvement in CR-QoL (OR 4.0).
Pulmonary rehabilitation improves CR-QoL in patients with chronic respiratory diseases. Identifying patients with lower baseline CR-QoL and higher disease impact may help guide targeted and more effective rehabilitation interventions.
