Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns
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...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2017 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p5362 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/5362 |
| Access Level: | acceso abierto |
| Palabra clave: | COPD chronic disease management CDM rehabilitation exacerbation admission |
| Sumario: | 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 (beta coefficient -0.785, P=0.014, and R-2=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. |
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