Telehealth Rehabilitation Lowers Hospital Readmissions After COPD Exacerbation, Study Finds
Video telehealth rehabilitation reduced the rates that patients with chronic obstructive pulmonary disease (COPD) had to be readmitted within 30 days after they were hospitalized for a pulmonary exacerbation, according to a study.
The findings were published in the American Journal of Respiratory and Critical Care Medicine in a study titled “Video Telehealth Pulmonary Rehabilitation Intervention in COPD Reduces 30-day Readmissions.”
According to the researchers, hospitalizations as a result of exacerbations in COPD patients are linked with respiratory morbidity and high healthcare costs, and accounts for nearly two-thirds of the total COPD healthcare costs. About one in five patients with COPD are readmitted within 30 days after hospital admission.
Although several hospitals have started intervention programs to lower the number of readmissions, the attempts have had minimal to modest success. However, studies have shown that pulmonary rehabilitation (multidisciplinary services aimed at improving the quality of life in patients) managed to reduce readmissions by 56%.
Consequently, researchers at the University of Alabama at Birmingham (UAB) tested the effect of a program using video telehealth rehabilitation.
The team enrolled COPD patients that were hospitalized for acute exacerbations, and identified through a daily hospital census (hospital-admitted patients). Except for specific conditions preventing them from participating in the exercises, all patients were included regardless of disease severity.
For 12 weeks, the patients attended a real-time video-conferencing intervention with 36 exercise sessions, following guidelines for conventional pulmonary rehabilitation. A physiologist provided the exercises that were based on outpatient exercise assessments, and adapted to the patient’s baseline functions.
Through the regimen, including stretching, breathing, and aerobic exercises, the goal was to reach heart rates between 60% and 80% of the maximum baseline recorded in a six-minute walk test.
Results showed a significant decrease in the 30-day all-cause readmissions among COPD patients who participated in the telehealth intervention (6.2% readmission), compared with patients who did not participate (18.1% readmission).
“Participating in an exercise program soon after hospitalization for an acute exacerbation of COPD is associated with a substantially lower readmission rate within 30 days of discharge,” Surya P. Bhatt, MD, associate professor in the division of pulmonary, allergy and critical care medicine at UAB, stated in a university news release written by Adam Pope.
“The video telehealth pulmonary rehabilitation program, by overcoming many barriers to early initiation of pulmonary rehabilitation, can expand access to pulmonary rehabilitation, especially for patients who live in rural areas,” Bhatt added.
Furthermore, the researcher emphasized that “by reducing COPD readmissions, this intervention has the potential to substantially reduce healthcare costs.”
Apart from COPD, the intervention approach can also be applied to the rehabilitation of patients with other chronic lung diseases. However, according to the team, the results need to be confirmed through randomized clinical trials.