Impact of Pulmonary Rehabilitation on Hospitalizations for Chronic Obstructive Pulmonary Disease Among Members of an Integrated Health Care System. Issue 5 (September 2015)

• Record Type: Journal Article
• Authors: Nguyen, Huong Q.; Harrington, Annie; Liu, In-Lu Amy; Lee, Janet S.; Gould, Michael K.
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 35:Issue 5(2015)
• Publication Date: 2015-09
• Subjects: Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000128
• Languages: English
• ISSNs: 1932-7501

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>PURPOSE:</title> <p>The evidence regarding the effects of pulmonary rehabilitation (PR) on health care resource use remains limited. This retrospective study evaluated the effects of PR on the primary outcome of all-cause hospitalizations and secondary outcomes of other health care use, exercise capacity, health-related quality of life (HRQOL), and body weight in patients with chronic obstructive pulmonary disease (COPD) in a large integrated health care system.</p> </sec> <sec> <title>METHODS:</title> <p>The PR cohort included 558 patients with a COPD diagnosis, age ≥ 40 years, who were treated with a bronchodilator or steroid inhaler, participated in 1 of 13 PR programs between January 1, 2008, and August 1, 2013, and were continuously enrolled in the health plan ≥ 12 months prior to and after PR. Two non-PR control cohorts were assembled for comparison. Data were extracted from electronic health records. The 6-minute walk test and St. George's Respiratory Questionnaire results were available for a subset.</p> </sec> <sec> <title>RESULTS:</title> <p>The proportion of patients who were hospitalized 12 months post-PR was lower compared with the 12 months prior (37% vs 45%, <italic>P</italic> = .001) while emergency department use was not different (52% vs 54%). Patients who declined PR for logistical reasons had a 40% higher risk of hospitalization than PR participants (relative risk = 1.40, 95% CI: 0.96-2.06, <italic>P</italic> = .08). There were significant improvements in the 6-minute walk test distance (+43 m) and the St. George's Respiratory Questionnaire total score (−9.6 points) but minimal changes in weight.</p> </sec> <sec> <title>CONCLUSIONS:</title> <p>Our finding that participation in PR is associated with reductions in hospitalizations corroborates previous studies. A notable strength of this study is the capture of complete utilization data.</p> </sec> </abstract>