Regular use of an OPEP device improves symptoms and quality of life in patients with COPD and sputum production.
Oscillating positive expiratory pressure (OPEP) devices are intended to promote sputum clearance and reduce coughing. However, there is limited evidence of its effectiveness in COPD. Researchers from the UK and Saudi Arabia therefore assessed in this study the impact of OPEP therapy on quality of life, cough and sleep disturbances in stable COPD patients who reported sputum production every day or most days. It was an assessor-blind, randomized, controlled, parallel-group study comparing 3 months of Acapella device use with usual care. The primary outcome measure was cough-related quality of life measured by the Leicester Cough Questionnaire (LCQ). Secondary outcome measures were fatigue (Functional Assessment of Chronic Illness Therapy, FACIT score) and global quality of life (EuroQol-5 Dimensions, EQ-5D). In a subgroup (n = 45), coughing and disturbance/movement during sleep were also objectively monitored.
122 participants (61 OPEP/ 61 control) were recruited, 40% female, 17% smoker, FEV1 38 (25-56)% predicted, age 62 ± 10 years. 103 of them completed the study (55 OPEP/48 control). The use of OPEP was associated with an improvement in LCQ score compared to control (mean difference 1.03; 95% CI 0.71-2.10; p = 0.03). There was also an improvement in FACIT score (4.68; 1.34-8.02; p < 0.001), EQ-5D (4.00; 0.49-19.75; p = 0.04) and cough frequency over 24 hours (-60; -43 to -95; p < 0.001). However, no statistically significant effect on sleep was found.
