Pulmonary rehabilitation programs are not followed by the majority of patients who suffer from chronic obstructive pulmonary disease (COPD). However, these treatments are reimbursed and effective.
Only a small portion of U.S. patients hospitalized with COPD participate in a respiratory rehabilitation program after discharge, according to new research published in the Annals of the American Thoracic Society. In the United States, this care is however reimbursed, as in France.
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease that affects the bronchi and is associated with many cardiovascular diseases. It progresses slowly and becomes disabling, characterized by a gradual decrease in breath. Largely underestimated, it probably affects more than 3.5 million people, or 6 to 8% of the French adult population. Responsible for 3% of deaths in France, COPD could be the 4th leading cause of death in 2030.
Returns to hospital
Respiratory rehabilitation programs offer physical training, self-management and nutritional advice, and psychological support. Their effectiveness, when they intervene three weeks after hospitalization, has been proven. In particular, they avoid returns to the hospital.
After examining the records of 223,832 patients hospitalized for COPD in 2012, the researchers showed that 4,225 (1.9%) had participated in respiratory rehabilitation within six months of their hospital stay. 6,111 (2.7%) had completed the program one year after hospitalization. Furthermore, 62% of people diagnosed with COPD had never heard of respiratory rehabilitation.
Far from places of care
Those who participated the least in respiratory rehabilitation were smokers, the most disadvantaged, patients who suffered from other chronic diseases or who lived far from places of care. Conversely, younger, male patients or those receiving home oxygen were more likely to benefit from these programs.
Among those who started respiratory rehabilitation, only a little more than half only carried out 16 sessions, while health insurance pays for 36. The researchers could not determine whether the low rates of use of pulmonary rehabilitation were due to lack of physician referrals, patients’ choice not to attend the program, or a combination of these two factors. They wish to continue their investigations in this direction.
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