New research conducted by The University of Texas Medical Branch at Galveston suggests that pulmonary rehabilitation (PR) therapy among older adults with chronic obstructive pulmonary disease (COPD) is underutilized – despite the health benefits and cost effectiveness of the therapy.
The study recently published in the Journal of Cardiopulmonary Rehabilitation and Prevention, is the first to describe the PR trends among COPD patients.
COPD is associated with disabling dyspnea (difficulty breathing), skeletal muscle dysfunction, significant rise in occurrence, and a common cause of death.
Current guidelines recommend PR to improve dyspnea, functional capacity, and quality of life. PR is designed to relieve symptoms and flares of COPD, and also to teach patients how to manage the disease.
Patients who receive PR show a reduction in shortness of breath, increased exercise ability, improved health-related quality of life, and less need to seek healthcare help.
“The majority of the economic burden of caring for COPD stems from hospitalization for sudden COPD flare-ups,” said Dr. Shawn Nishi, an assistant professor at UT’s Internal Medicine Division of Pulmonary, Critical Care and Sleep Medicine, in a press release. “PR is known to reduce COPD-related emergency room visits, hospitalizations and unscheduled doctor visits. PR provides an overall cost-effective management for a health care system.”
In the study, researchers analyzed PR trends and patterns among approximately 33,000 COPD patients with Medicare insurance between 2003 and 2012.
The team observed a modest increase in patients using PR; from 2.6% in 2003 to 3.7% in 2012; but overall rates of PR use remains low.
Results revealed that patients with COPD who were more likely to get PR were younger, non-Hispanic white, higher in socioeconomic status, with multiple health issues, and patients with multiple evaluations by a pulmonary doctor.
The largest PR increases during the study time, were among male patients older than 75 years, people from Black ethnic backgrounds, patients with higher socioeconomic status, and among those with other health issues.
“Starting in 2015, the Centers for Medicare and Medicaid Services added COPD to the list of conditions subject to penalties for readmissions to the hospital within 30 days after release,” said Nishi. “As the health care system shifts from volume- to value-based reimbursement from CMS, it is prudent for health systems to offer hospital- or community-based PR services to its patients with COPD.”