Q&A: Pulmonary Rehabilitation Linked to Significant Cost Savings in COPD Care

Photo Credit: Mohammed Haneefa Nizamudeen

A recent review of the health benefits and fiscal benefits of pulmonary rehabilitation encourages more healthcare practitioners to include this regimen in their treatment protocols.

Although studies have outlined the benefits of pulmonary rehabilitation (PR) as part of the treatment plan for chronic obstructive pulmonary disease (COPD), standardized participation in PR remains low. PR is a comprehensive and multidisciplinary program that consists of patient-focused exercise training that advances in degree of difficulty, disease state and treatment education, and self-management strategies. Patients with COPD undergo this program with the supervision of a trained healthcare professional. Studies have shown that patients who participate faithfully in PR can improve their capacity to perform exercise, increase their healthcare-related quality of life, and improve their dyspnea. As with all rehabilitative regimens, a physician’s recommendation and encouragement to participate can help achieve follow-through.

Another significant benefit of PR is the reduced healthcare costs, estimated to result in healthcare savings among patients with a history of COPD hospitalization. The cost savings stem from a reduced rehospitalization rate and skilled nursing facility days. Despite all of these benefits, hesitancy in participation remains. To address this, Chris L. Mosher, MD, MHS, and colleague Courtney E. Lamberton, MD, developed a comprehensive review of PR’s clinical benefits and cost benefits in caring for patients with COPD. Their review was published in Respiratory Care.

Physician’s Weekly (PW) spoke with Dr. Mosher regarding the topics explored in their review.

PW: Why did you feel this topic needed exploration?

Dr. Mosher: Despite a wealth of evidence that supports PR as an effective medical intervention for patients with COPD, participation in PR remains low at less than 5% in the United States. Our summary of the numerous benefits of PR will encourage clinicians to refer COPD patients to PR to help increase their participation in this important treatment. Furthermore, we highlighted emerging data related to the cost savings estimated to be associated with the involvement in PR among older adults hospitalized for COPD in the United States. We hope this evidence motivates multiple healthcare stakeholders, such as health plans, hospital leadership, and health policy advocates, to promote PR and work toward overcoming barriers to participation for all qualified patients.

What are the most important findings from your study for physicians to understand?

Our study summarizes existing evidence supporting PR as a standard of care therapy for patients with COPD. PR has been associated with improved shortness of breath, quality of life, and exercise tolerance among patients with COPD. Additionally, among patients hospitalized for COPD, PR has been associated with reduced COPD hospitalizations and improved survival. Lastly, among patients hospitalized for COPD, PR is estimated to be cost-effective and result in cost savings.

How can these findings be incorporated into practice?

Robust evidence supports the clinical and, more recently, financial benefits associated with participation in PR among patients with COPD. Based on the evidence, PR should be a cornerstone treatment for COPD. Clinicians should refer and educate patients on the importance of PR. Healthcare stakeholders should develop novel strategies to help overcome barriers to PR, as participation not only benefits patients but may also reduce healthcare costs.


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