Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns
Lalmolda, Cristina (Universitat Autònoma de Barcelona)
Coll-Fernandez, Roser (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Martínez, Natalia (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Baré i Mañas, Marisa (Institut Català de la Salut. Servei d'Atenció Primària del Vallès Oriental)
Teixidó Colet, M. (Institut Català de la Salut. Servei d'Atenció Primària del Vallès Oriental)
Epelde, Francisco (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Monsó, E. (Universitat Autònoma de Barcelona)

Date:	2017
Abstract:	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. 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. 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. 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 R 2 =0. 219). 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	COPD ; Chronic disease management ; CDM ; Rehabilitation ; Exacerbation ; Admission
Published in:	International journal of COPD, Vol. 12 (2017) , p. 2531-2538, ISSN 1178-2005

DOI: 10.2147/COPD.S138451
PMID: 28883720

8 p, 317.9 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles