Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns

C. Lalmolda, R. Coll-Fernández, N. Martínez, M. Baré, M. Teixidó Colet, F. Epelde, E. Monsó

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3 Citations (Scopus)

Abstract

© 2017 Lalmolda et al. Background: Pulmonary rehabilitation (PR) is recommended after a severe COPD exacerbation, but its short- and long-term effects on health care utilization have not been fully established. Aims: The aims of this study were to evaluate patient compliance with a chronic disease management (CDM) program incorporating home-based exercise training as the main component after a severe COPD exacerbation and to determine its effects on health care utilization in the following year. Materials and methods: COPD patients with a severe exacerbation were included in a case-cohort study at admission. An intervention group participated in a nurse-supervised CDM program during the 2 months after discharge, comprising of home-based PR with exercise components directly supervised by a physiotherapist, while the remaining patients followed usual care. Results: Nineteen of the twenty-one participants (90.5%) were compliant with the CDM program and were compared with 29 usual-care patients. Compliance with the program was associated with statistically significant reductions in admissions due to respiratory disease in the following year (median [interquartile range]: 0 [0–1] vs 1 [0–2.5]; P=0.022) and in days of admission (0 [0–7] vs 7 [0–12]; P=0.034), and multiple linear regression analysis confirmed the protective effect of the CDM program (β coefficient -0.785, P=0.014, and R2=0.219). Conclusion: A CDM program incorporating exercise training for COPD patients without limiting comorbidities after a severe exacerbation achieves high compliance and reduces admissions in the year following after the intervention.
Original languageEnglish
Pages (from-to)2531-2538
JournalInternational Journal of COPD
Volume12
DOIs
Publication statusPublished - 23 Aug 2017

Keywords

  • Admission
  • CDM
  • COPD
  • Chronic disease management
  • Exacerbation
  • Rehabilitation

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    Lalmolda, C., Coll-Fernández, R., Martínez, N., Baré, M., Teixidó Colet, M., Epelde, F., & Monsó, E. (2017). Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns. International Journal of COPD, 12, 2531-2538. https://doi.org/10.2147/COPD.S138451