{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:07:23Z","timestamp":1793250443960,"version":"4.5.0"},"reference-count":74,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Global Health Research","award":["17\/63\/20"],"award-info":[{"award-number":["17\/63\/20"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Tuberculosis (TB) is a major worldwide cause of disability, with TB survivors experiencing a significant and often underrecognized burden, and approximately half going on to develop post-tuberculosis lung disease (PTLD). Pulmonary rehabilitation may offer effective disease management, but there is a lack of evidence in PTLD populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to determine the clinical and cost effectiveness of pulmonary rehabilitation for adults living with PTLD in Kyrgyzstan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-blind randomized controlled trial, conducted March 2021 to June 2022 in Bishkek, Kyrgyzstan, compared supervised pulmonary rehabilitation to usual care for adults living with PTLD. Participants were randomized (1:1) to receive either usual care (control) or culturally adapted pulmonary rehabilitation (intervention), comprising individually prescribed and tailored exercise and self-management education. The primary outcome was change in maximal exercise capacity, measured by the incremental shuttle walking test (ISWT), from baseline to the end of 6 weeks of pulmonary rehabilitation, analyzed by intention-to-treat analysis. Secondary outcomes included health-related quality of life (HRQoL) and cost-effectiveness analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred fourteen participants (mean\u2009\u00b1\u2009SD, 43.3\u2009\u00b1\u200915.2\u2009years; 57% male) received either supervised pulmonary rehabilitation or usual care. Compared with the control group, changes in exercise capacity and HRQoL from baseline were significantly greater in the intervention group (ISWT: 123.0\u2009m [95% CI, 81.2-164.8 m], P\u2009&amp;lt;.001; EQ-5D-5L Visual Analogue Scale: 20.2 [95% CI 15.5-24.9], P\u2009&amp;lt;.0001). The intervention group saw a significant increase in quality-adjusted life-years (QALYs) over the control group (0.2 [95% CI, 0.1-0.2]). We calculated a total program cost of US$5686.5 (US$95 per patient who received pulmonary rehabilitation), giving a program cost, after adjusting for purchasing power, of US$2143.2 per QALY (95% CI, $1621.9-$2663.9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adults with PTLD in Kyrgyzstan, a culturally adapted pulmonary rehabilitation program significantly improved exercise capacity and HRQoL compared with usual care and was both clinically and cost effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag062","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:41:38Z","timestamp":1774320098000},"page":"1141-1153","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and cost effectiveness of pulmonary rehabilitation for people with post-tuberculosis lung disease in Kyrgyzstan: a single-blind randomized controlled trial"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-399X","authenticated-orcid":false,"given":"Azamat","family":"Akylbekov","sequence":"first","affiliation":[{"name":"National Centre of Cardiology and Internal Medicine named after academician M. 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