Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD

Abstract

Objectives: Pulmonary rehabilitation (PR) improves exercise capacity and health-related quality of life (HRQoL), and reduces health care utilisation. This study quantified outcomes of a PR program over a 6-year period and determined the effects of PR on hospitalisation. Methods:Patients with chronic obstructive pulmonary disesae (COPD) who entered an 8-week outpatient PR program from 1998 to 2003 were included. Functional exercise capacity (6-minute walk distance [6MWD]) and HRQoL (Chronic Respiratory Disease Questionnaire) were measured before and following PR. The number of hospital admissions and total bed-days due to a COPD exacerbation in the 12 months before and following PR were recorded.Setting: Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia.Results: 187 (73%) of the 256 patients who entered PR completed the program. Improveme n t s i n 6 M W D ( 4 0 4 . 2 ± 1 1 4 . 6 m t o 43 9 .6 ± 11 5 .0 m, P < 0. 00 1 ) a n d H R Q o L (4.1 ±0.9 points per item to 4.9 ±0.9 points per item, P < 0.001) occurred following PR. There was a 46% reduction in the number of patients admitted to hospital (71 to 38) with a COPD exacerbation and a 62% reduction in total bed-days (1131 to 432) following PR. Conclusion

Pulmonary Rehabilitation: A Retrospective Study in Eastern North Carolina

“…This outcome would likely result in a reduction in health care costs, which is consistent with the findings of other studies [18][19][20]. In one such study by Raskin and colleagues, 128 patients received PR at 11 outpatient centers, and there were 0.25 fewer hospitalizations in the year following PR [21].…”

Ground-based walking training improves quality of life and exercise capacity in COPD

“…The study had a low drop-out rate of 9%, which is in contrast with higher attrition from clinical pulmonary rehabilitation programmes [2]. One reason for this difference may be that ''drop out'' from a clinical pulmonary rehabilitation programme is often reported when patients do not attend training, whereas, in a clinical trial, participants remain in the trial as long as some of the final assessments are performed (i.e.…”

“…Pulmonary rehabilitation has been shown to improve health-related quality of life (HRQoL) [1] and exercise capacity, as well as reduce hospital admissions and length of stay in people with chronic obstructive pulmonary disease (COPD) [2][3][4]. Globally, the demand for pulmonary rehabilitation far outweighs the availability of programmes [5][6][7][8][9][10].…”

Outpatient-Based Pulmonary Rehabilitation for COPD: A Cost of Illness Study

“…Using a similar population group (mean age 68 years, FEV1 44% predicted), a study in 10 centres in California reported significant improvement, although the benefits regressed over an 18-month followup [10]. An Australian study with 187 patients also showed improvements in 6MWD and HRQL following PR and reported a 46% reduction in the number of patients admitted to hospital with an exacerbation and a 62% reduction in total bed days following PR [22]. Griffiths et al reported in 200 patients, mainly with COPD.…”