Outpatient-Based Pulmonary Rehabilitation for COPD: A Cost of Illness Study

Abstract

Pulmonary rehabilitation (PR) as recommended by COPD guidelines is a multimodality educational, self-management, supervised exercise program, resulting in improved symptom control, quality of life, and reduction of exacerbations, but there is a need to establish the affordability of PR for healthcare providers. We designed a cost-of-illness study of PR in advanced COPD, with an 8-week hospital-based program, measuring direct healthcare costs for 12 months before and after PR. In 31 patients (female = 16), aged 68 (±8) years, and FEV 1 % predicted to be 40 (±16.6), there was a reduction in inpatient hospital stay by net 2.35 days (78%; P = 0.027) and routine primary care visits. Costs were reduced by £1835 per person (base year 2008), with a saving of £791 to 1313 GBP per person, per year. Therefore, PR provision in COPD is likely to be affordable due to reduced direct healthcare costs, even without considering the individual and societal benefits.

Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)

“… 3 9 Evidence-based non-pharmacologic treatment for COPD includes smoking cessation, influenza vaccine and pulmonary rehabilitation. 10 11 Pulmonary rehabilitation is a multidisciplinary programme including exercise training, education and psychosocial support, generally delivered in an outpatient setting. Pulmonary rehabilitation is one of the most effective therapies for COPD, improving quality of life, exercise tolerance and breathlessness 12 as well as reducing mortality and rehospitalisation.…”

Using self-determination theory to predict self-management and HRQoL in moderate-to-severe COPD

“…Given that 31% of people invited to PR do not attend the initial assessment (Steiner et al, 2016 ), there are a large number of people with COPD for whom an intervention may be beneficial. PR is effective at improving health outcomes (McCarthy et al, 2015 ) and is also cost-effective (Chakravorty, Fasakin, Paine, Narasimhaiah, & Austin, 2011 ; Griffiths, Phillips, Davies, Burr, & Campbell, 2001 ); therefore, any intervention that is successful in improving PR attendance, is likely to have significant benefits for those with COPD. Thus, by highlighting the different elements that combine to motivate an individual with moderate-to-severe COPD to self-manage their condition, this study provides a useful first-step in informing future research, interventions, and healthcare practice.…”

Home‐based pulmonary rehabilitation for COPD using minimal resources: An economic analysis

“…No previous economic analysis of pulmonary rehabilitation has compared a home‐based model to a centre‐based programme. Past work has been purely descriptive, comparing centre‐based programmes to usual care or comparing two different models of centre‐based pulmonary rehabilitation (hospital versus community centre) . Our analysis used individual‐level data collected as part of an RCT, undertaken with reference to economic evaluation recommendations and reflecting a ‘real‐life’ clinical setting.…”