Article Text
Abstract
Introduction Little has been published regarding the relationship between physical activity (PA) and outpatient treated, mild to moderate acute exacerbation of chronic obstructive pulmonary disease exacerbations (AECOPD). The purpose of this study was to determine the association between self-reported PA and outpatient treated AECOPD over 2 years using real-world data obtained from existing electronic medical records (EMRs).
Methods We included 44 896 patients with a chronic obstructive pulmonary disease diagnosis from the EMR in this retrospective cohort study. Moderate to vigorous PA was measured via patient self-report, obtained during routine clinical care; patients were classified as inactive (0 min/week), insufficiently active (1–149 min/week) or active (≥150 min/week). AECOPDs were measured using both encounter and prescription fill (antibiotics and/or oral steroids) data. We used Poisson regression models to compare the unadjusted and adjusted rates of outpatient treated AECOPD over 2 years across the PA categories.
Results In adjusted models, the 2-year AECOPD incidence rate ratio (IRR) was not different between the inactive and insufficiently inactive groups (IRR 0.98, 95% CI 0.96 to 1.01) and only marginally meaningful lower for the active group (IRR 0.97, 95% CI 0.95 to 0.98). Sensitivity analyses of patients meeting or not meeting obstructive criteria produced similar results with generally weak or non-significant associations.
Conclusion The lack of an association between PA and AECOPD contrasts with previous published findings of a strong relationship between moderate to vigorous PA and hospitalisations for severe AECOPD. This difference could partially be attributed to the imprecision of our measurements for both the exposure and outcome.
- COPD exacerbations
- exercise
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Footnotes
Contributors Contributions from all authors meet the ICMJE authorship criteria.
Funding This study used the infrastructure developed by the Patient Outcomes Research to Advance Learning Network, a consortium of three integrated healthcare delivery systems (Kaiser Permanente, HealthPartners and Denver Health) and their affiliated research centres. Research reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) award (CDRN-1306-04681, phase II). The statements and opinions in this publication are solely the responsibility of the authors and do not necessarily represent the views of the PCORI, its board of governors or methodology committee.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval Kaiser Permanente Southern California and Kaiser Permanente Pacific Northwest institutional review boards approved this study.
Provenance and peer review Not commissioned; internally peer reviewed.
Data availability statement Data are available upon reasonable request. Due to the significant time and costs associated with the removal of all identifiers to protect the identities of participants, the requester will be asked to incur these costs.