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Few patients with COPD use pulmonary rehabilitation

Recent findings published in the Journal of Cardiopulmonary Rehabilitation and Prevention showed that only 3.7% of older patients with chronic obstructive pulmonary disease used pulmonary rehabilitation as of 2012.

“From 2003 to 2012, subjects enrolled in [pulmonary rehabilitation (PR)] modestly increased,” Shawn P.E. Nishi, MD, co-author and assistant professor of internal medicine at the University of Texas Medical Branch, and colleagues wrote. “However, despite becoming an allowable benefit under Medicare since 2010, PR use remains low.”

In 2010, PR was approved for both Medicare and Medicaid. However, there are no studies that have described PR use among patients with chronic obstructive pulmonary disease (COPD) in the United States.

To assess trends in PR use, Nishi and colleagues performed a retrospective study. They identified Medicare beneficiaries with COPD who received PR between 2003 and 2012, and performed a multivariable analysis to identify factors associated with its use.

They found that the number of individuals with COPD who received PR increased from 2.6% in 2003 to 3.7% in 2012 (P = .001). In the multivariable analysis, being younger, having a non-Hispanic white race, belonging to a higher socioeconomic class, having multiple comorbidities and being evaluated by a pulmonary physician were all associated with PR use. In addition, the modest increase in PR use was primarily an increase in frequency for those who already used PR, and not an increase in new PR users.

The result of low PR use is consistent with previous international studies that reported between a 1% and 2% PR use in patients with COPD, the researchers wrote. A recent survey showed that although 32% of primary care physicians had PR available, only 3% believed it was beneficial for patients.

“As we shift from volume- to value-based reimbursement, it is prudent for every health system to offer hospital- or community-based PR services to its patients with COPD,” the researchers wrote. “Products are under development to offer low cost PR applications for patients who are technology savvy and/or located in a health care system without PR in the vicinity.” – by Will Offit

Disclosures: The researchers report no relevant financial disclosures.