Pico Question on Copd

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Jeffrey Bourguignon Best Evidence Paper EM 6305 Fall 2011 PICO Question In COPD patients, does breathing rehabilitation or anxiolytics produce a greater reduction in anxiety and subsequent dyspnea? Search Strategy The search terms I initially used to find material suitable for this assignment were: COPD, anxiety, pulmonary, rehabilitation, treatment, dyspnea, quality of life. Search Outcome My search returned 80 papers, of which 22 were free full texts. 21 of the papers were relevant to my query and supported pulmonary rehabilitation programs for patients with COPD to reduce anxiety and thus, dyspnea. Relevant Articles Table Article | Patient Group | Study Type | Outcomes | Key Results | Study Weaknesses | 1 | 45 patients - 13 male, 32 female, mean age 67.4 years | Observational Study | Pts who completed pulmonary program showed improvement on all four scales. | Program significantly reduced anxiety. | Small study group | 2 | 26 rehabilitation patients with COPD were compared with 19 control patients withCOPD similar in age, gender, COPD severity and other variables. | Observational Study | Pulmonary rehabilitation program leads to a benefit inanxiety and depressive symptoms in COPD patients. | The benefit was especially significant inanxiety symptoms. In addition to the improvement in psychological symptoms, the health status, exercise tolerance and dyspnea intensity were also significantly improved in COPD patients who underwent the rehabilitation program. | Small study group, only one rating scale used. | 3 | 24 total patients – 14 control group, 10 treatment group | RCT | Significant improvement in depression, anxiety, ADLs. | Dyspnea scale was significantly improved in treatment group. | Small control group and small overall study | 4 | 81 patients with COPD who completed PR at a Veterans Administration Medical Center. | Cohort Study
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