The Journal of the American Medical Association (JAMA) has published the results of a retrospective observational study which which looked at more than 197,000 Medicare beneficiaries discharged after hospitalization for COPD, who had pulmonary rehabilitation initiated within 3 months of discharge, compared with patients who had later (initiated > 90 day post-discharge) or no initiation of pulmonary rehabilitation. The study showed that there initiating pulmonary rehabilitation within the first ninety day post-hospital discharge was “significantly associated with lower risk of mortality at 1 year”. The study authors found that the mortality rate was “7.3% of patients who initiated pulmonary rehabilitation within 90 days and 19.6%of patients who initiated pulmonary rehabilitation after 90 days or not at all.”
Unfortunately, the vast majority of COPD patients still do not receive pulmonary rehabilitation. In an editorial published in the same issue of JAMA, Carolyn L. Rochester, MD, and Anne E. Holland, PT, PhD, discuss the low percentage of individuals to participate in pulmonary rehabilitation programs. “Despite its well-documented meaningful benefits for patients and health care systems, and recommendations for its use in international guidelines, pulmonary rehabilitation is underutilized. For example, in the US, only an estimated 3% to 4% of Medicare beneficiaries with COPD receive pulmonary rehabilitation, and less than 2% of individuals hospitalized with COPD exacerbation receive this therapy. These numbers are likely even lower for patients with respiratory disorders other than COPD.”
Citations:
Lindenauer PK, Stefan MS, Pekow PS, et al. Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries. JAMA. 2020;323(18):1813–1823. doi:10.1001/jama.2020.4437