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COPD patients rarely receive pulmonary rehabilitation despite health benefits

12 November 2018 – Only a small part of patients hospitalized for COPD or chronic obstructive pulmonary disease participates in lung rehabilitation after hospitalization, although such programs recommend Medicare covers costs, according to new research published on the Internet Annals of American Thoracic Society.

In "Participation in lung rehabilitation after hospitalization for COPD among Medicare users", Kerry A. Spitzer, MD, MPA and co-authors reported that in 2012 only 1.9% of patients with COPD began pulmonary rehabilitation within six months after hospitalization deteriorating COPD. Despite the fact that two years ago, Medicare's policy changed its coverage for lung rehabilitation services, which effectively provided lung refoulement for millions of US patients for the first time.

COPD is a chronic illness, and the fourth leading cause of death in American Pulmonary Rehabilitation provides exercise exercises, self-management advice, nutrition counseling and emotional support. Despite the proven benefits, ATS's Wakefield Research survey found that 62 percent of people with COPD diagnosis have never heard of pulmonary rehabilitation.

It has been shown that the intervention adapted to the patient improves physical and mental well-being and quality of life. Other studies have shown that pulmonary rehabilitation reduces COPD deterioration, which often leads to hospitalization. Clinical guidelines recommend that patients begin pulmonary rehabilitation within three weeks of outbreaks.

According to the study, Dr. Sc. Peter Lindenauer, a physician at Baystate Medical Center, and director of the Institute for Healthcare and Population Science at the Massachusetts Medical School, is increasingly recognizing the benefits of lung rehabilitation.

As hospitals and health systems, like ours, increase efforts to keep patients with healthy COPD and out of the hospital the priority of enrolling patients into our rehabilitation program before hospitalization, "said Dr. Lindeauer, see improvements in rehabilitation rates among patients with COPD.

After reviewing the records of 223,832 patients hospitalized for COPD in 2012, the researchers found:

  • 4,225 (1.9%) received pulmonary rehabilitation within six months of removal from the hospital.
  • 6,111 (2.7 percent) received pulmonary rehabilitation within one year of being released from hospital.
  • White males, males, younger patients and those in home-breathing had a greater likelihood of receiving pulmonary rehabilitation.
  • Smokers and those who lived more than 10 miles away from pulmonary rehabilitation programs who belong to lower socioeconomic groups and face additional chronic illnesses and previous hospitalizations were less likely to get pulmonary rehabilitation.
  • Among those who started pulmonary rehabilitation, more than half had completed at least 16 sessions. Medicare usually pays up to 36 sessions.

Limitations of the study include the fact that the researchers could not determine whether low rates of lung rehab were due to lack of doctor recommendations, patients who did not choose to participate or combine two factors.
Dr. Spitzer, the author of lead studies and senior clinical research coordinator at Baystate, believes more research is needed to understand why patients do not receive pulmonary rehabilitation.

"Unfortunately, many patients are faced with more obstacles to participation, such as family responsibilities or transportation, and participation rates are particularly low among the vulnerable population," she said. "We have a lot of knowledge about how hospitals can help address these challenges."


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ON Annals of American Thoracic Society (AnnalsATS)

AnnalsATS is a journal published by the American Journal of Thoracic Society. The journal provides updated and authoritative coverage of adult and pediatric remedies for lung, respiratory and critical care for adults. The scope of the journal covers the content to be applied to clinical practice, the formative and continuing education of clinical specialists and the improvement of public health. Editor: David Lederer, MD, MS, Associate Professor of Medicine and Epidemiology and Principal Associate for Clinical and Translation Research at Columbia University.

About the American abdominal society

The American Belly Company founded in 1905 is the world's leading medical association dedicated to the promotion of pulmonary, critical and medical care. More than 16,000 members of the Society are preventing and resisting respiratory illnesses throughout the world through research, education, patient care and advocacy. ATS publishes three journals, The Respiratory and Critical Care Medicine. American Journal of Respiratory Cell and Molecular Biology and Annals of American Thoracic Society.

The ATS will hold the International Conference 2019, 17-22. May, in Dallas, Texas, where world-renowned experts will share the latest scientific research and clinical efforts in pulmonary, critical and sleep medicine.

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