Results from recent studies and trials conflict on whether pulmonary rehabilitation reduces physician visits and hospitalizations for patients with COPD exacerbations, but data shows it is overall beneficial.
“Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may require admission to hospital which can put a heavy burden on health systems,” Elizabeth Moore, MSc, of the Department of Respiratory Epidemiology Occupational Medicine and Public Health at Imperial College of London, and colleagues wrote. “Pulmonary rehabilitation is an important intervention in the management of COPD. However, the evidence relating to whether it reduces emergency room (ER) visits and hospitalizations for AECOPD is [inconclusive].”
The researchers identified and reviewed cohort studies and randomized controlled trials that evaluated AECOPD–related hospitalizations to assess the effect of pulmonary rehabilitation on patients with AECOPD. Unscheduled hospitalizations and emergency room visits were used to measure outcomes.
A meta-analysis of 18 studies compared hospitalization rates before and after pulmonary rehabilitation between recipients and non-recipients.
Overall, within ten randomized controlled trials, patients in the pulmonary rehabilitation group were hospitalized less frequently (0.62 hospitalizations/patient-year, 95% CI 0.33-1.16) compared to patient in the control group (0.97 hospitalizations/patient-year, 95% CI 0.67-1.40).
Additionally, five studies indicated that admission rates were significantly higher 12 months before rehabilitation compared to 12 months after (1.24 hospitalizations/patient-year, 95% CI 0.66-2.3 vs. 0.47 hospitalizations/patient-year, 95% CI 0.28-0.79).
