Friday , May 14 2021

Pulmonary Rehabilitation in COPD: Insufficient Use – Medical News



It has been proven that patient-adjusted intervention improves physical and psychological well-being and quality of life

Only a small proportion of patients hospitalized due to HOBP or chronic obstructive pulmonary disease participate in a lung rehabilitation program after hospitalization, although such programs are recommended and Medicare covers their costs, according to new research published online at the Annals of American Thoracic Society.

In the study "Participation in pulmonary rehabilitation after hospitalization for HOBP among users of Medicare", Dr. Kerry A. Spitzer, PhD, MPA and co-authors reported that in 2012 only 1.9 per cent of patients with HOBP started lung rehabilitation throughout the country, within six months after the worsening HOBP was hospitalized.

This is despite the fact that two years earlier, Medicare's policy has changed to ensure coverage of pulmonary rehabilitation services, effectively offering pulmonary rehabilitation to millions of American patients. UU For the first time

HOBP is a chronic disease and the fourth cause of death in the United States. UU Pulmonary Rehabilitation provides physical training, self-management advice, nutrition counseling and emotional support. In spite of proven benefits, a study by ATS's Vakefield Research found that 62% of people with a diagnosis of HOBP never heard of pulmonary rehabilitation.

It has been shown that patient-adjusted intervention improves the physical and psychological well-being and quality of life. Other studies have shown that pulmonary rehabilitation reduces the deterioration of HOBP, which often leads to hospitalization. Clinical guidelines recommend that patients begin pulmonary rehabilitation within three weeks after the discharge of the hospital.

According to research by the leading author, Peter Lindenauer, MD, MSc, Baistate Medical Center and director of the Institute for Health Protection and Population Science at the University of Massachusetts Medical School, is gaining recognition of the benefits of pulmonary rehabilitation.

As hospitals and health systems, like ours, increase efforts to make patients with HOBP healthy and out of hospital, we prioritize patient enrollment in our rehabilitation program before dismissal, "said Dr. Lindeauer." As a result, we see improvements in readmission in patients with HOBP. "

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

  • 4.225 (1.9 percent) received pulmonary rehabilitation within six months of absence from the hospital.
  • 6,111 (2.7 percent) received pulmonary rehabilitation within one year after being discharged from the hospital.
  • White people, men, younger patients, and those who received oxygen at home were more likely to receive pulmonary rehabilitation.
  • Smokers and those who live more than 10 miles away from lung rehabilitation programs, belonging to lower socioeconomic groups and with additional chronic illnesses and previous hospitalizations, were less likely to receive pulmonary rehabilitation.
  • Among those who started pulmonary rehabilitation, more than half completed at least 16 sessions. In general, Medicare will pay up to 36 sessions.

The limitations of the study include the fact that researchers could not determine whether low rates of pulmonary rehabilitation were due to a lack of medical references, to patients who did not choose to attend or to combine two factors.

Dr Spicer, lead author of the study and lead clinical coordinator for clinical research at Baistate, believes that more research is needed to understand why patients are not receiving pulmonary rehabilitation.

"Unfortunately, many patients face more barriers to participation, such as family responsibilities or traffic, and participation rates are particularly low among vulnerable populations," he said. "We have a lot to learn about how hospitals can help meet these challenges."


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