Impact of Pulmonary Rehabilitation on Hospitalizations for Chronic Obstructive Pulmonary Disease Among Members of an Integrated Health Care System

Nguyen, Huong Q.; Harrington, Annie; Liu, In Lu Amy; Lee, Janet; Gould, Michael K.

doi:10.1097/hcr.0000000000000128

Cited by 12 publications

(5 citation statements)

References 30 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, the data used are from routinely collected primary care and hospital sources, reflecting real life patients seen in every day clinical practice. This was a large cohort study and the results are similar to those of other studies including a retrospective cohort study in California by Nguyen et al, 21 which compared rates of exacerbations in 558 patients who received pulmonary rehabilitation in the stable state to 1,114 patients who did not. 12 months after the programme, 10% of the non-intervention group were hospitalized for an exacerbation, whereas 18% of the pulmonary rehabilitation group were hospitalized.…”

Section: Discussionsupporting

confidence: 77%

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

Moore

Newson

Joshi

et al. 2017

Chest

View full text Add to dashboard Cite

Conflict of Interest DisclosuresJKQ reports grants from the Medical Research Council (MRC), GlaxoSmithKline (GSK), British Lung Foundation (BLF), Wellcome Trust, during the conduct of the study, and personal fees from AstraZeneca and Boehringer Ingelheim, outside of the submitted work. MS reports other current research grants from Arthritis Research UK, Public Health England and the EU EITHealth Programme, with no conflicts of interest. SS reports grants from the National Institute for Health Research (NIHR), GlaxoSmithKline (GSK), Boehringer Ingelheim and Novartis and personal fees from Novartis and AstraZeneca. All other authors report no other conflicts of interest. 2 AbstractBackground: In previous systematic reviews, predominantly of randomised controlled trials,

show abstract

Section: Discussionsupporting

confidence: 77%

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

Moore

Newson

Joshi

et al. 2017

Chest

View full text Add to dashboard Cite

show abstract

“…An important and possibly confounding finding was related to our sample. We likely had an atypical sample, similar to that reported from several of Nguyen and colleagues studies (Nguyen et al, 2013, 2015). These peoples were moderate to highly educated, were insured, had previously demonstrated self-management skills with some degree of proficiency, and were technologically savvy, which could result in limited opportunities for improvement from baseline.…”

Section: Discussionsupporting

confidence: 75%

“…Contrarily, researchers have parsed some of these comprehensive interventions into smaller, more manageable programs centered on pulmonary rehabilitation (PR) programs and principles. PR and interventions paired with PR have covered many educational topics pertinent to those with COPD, ranging from exercise to mental well-being, symptom control, and exacerbation planning (Nguyen, Gill, Wolpin, Steele, & Benditt, 2009; Nguyen, Harrington, Liu, Lee, & Gould, 2015; Wouters et al, 2018). These interventions have been shown to reduce symptom distress, improve self-care behavior performance, and improve HRQoL.…”

Section: Self-carementioning

confidence: 99%

Effects of a Digital Self-care Intervention in Adults with COPD: A Pilot Study

et al. 2019

View full text Add to dashboard Cite

Self-care improves quality of life, and reduces exacerbations and mortality risk in people with chronic obstructive pulmonary disease (COPD). The purpose of this report is to describe the development and testing of the feasibility and acceptability of a digital, educational self-care intervention designed to improve self-care ability, adherence, knowledge, somatic symptoms, anxiety, and depressive symptoms. This pilot study was a quasi-experimental, repeated measures design. Self-care behaviors were identified, and educational modules were developed and built into a web-based platform. Twenty participants were enrolled to determine feasibility, acceptability, and preliminary efficacy. The intervention was deemed acceptable and feasible as evidenced by > 95% completion rates and high degree of participation. Overall, the intervention was well received and is feasible for future home-based interventions in those with COPD. Results included significant improvements in adherence and knowledge, and significant associations between self-care ability, adherence, and depressive symptoms.

show abstract

“…15 Therefore, what does this study tell us about the "true" effect of PR on primary and secondary health-care use? Although caution should be exercised in assigning too much weight to observational studies when they conflict with evidence from randomized controlled trials, the current report and other cohort studies 16 suggest that the impact on this prized outcome may be variable and that current health data/record systems (in the United Kingdom at least) are insufficiently sensitive to detect such an impact. This is a salutary lesson for payers/ commissioners; expecting simple observable cause-andeffect relationships between service change and clinical outcome (and health-care costs) is unrealistic and should not be a prerequisite for the ongoing provision of interventions that have proven effectiveness in clinical trials.…”

mentioning

confidence: 72%

Pulmonary Rehabilitation

Evans

Steiner

2017

Chest

View full text Add to dashboard Cite

Pulmonary rehabilitation (PR) comprising an individually prescribed supervised exercise training program alongside interdisciplinary and selfmanagement education is the most effective therapy available for people with COPD. PR delivers clinically important improvements in dyspnea, physical capacity, and quality of life. These benefits are summarized in a series of systematic reviews, the most recent of which concluded that further trials testing the effectiveness of PR were no longer needed. 1 An additional benefit of completion of PR may be reduced days spent in hospital 2 or risk of readmission if undertaken in the immediate aftermath of hospitalization for an acute exacerbation of COPD (AECOPD). 3 These outcomes, although less secure with respect to scientific evidence, have received increasing attention because of the costly nature of care for AECOPD and because of the recognized underprovision and underuse of PR internationally. 4-6 Therefore, one of the drivers for enhancing referral and uptake of PR is recognition of the need to rebalance COPD care toward the provision of such "higher-value" interventions, 7 thereby mitigating the high costs of COPD-associated acute care. The recent UK national audit of PR services indicates that patient-centered benefits

show abstract

Impact of Pulmonary Rehabilitation on Hospitalizations for Chronic Obstructive Pulmonary Disease Among Members of an Integrated Health Care System

Abstract: 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.

Cited by 12 publications

References 30 publications

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

Effects of a Digital Self-care Intervention in Adults with COPD: A Pilot Study

Pulmonary Rehabilitation

Contact Info

Product

Resources

About