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Review
. 2024 May 28;69(6):686-696.
doi: 10.4187/respcare.11541.

Review of the Evidence for Pulmonary Rehabilitation in COPD: Clinical Benefits and Cost-Effectiveness

Courtney E Lamberton  1 , Christopher L Mosher  2
Affiliations
Review

Review of the Evidence for Pulmonary Rehabilitation in COPD: Clinical Benefits and Cost-Effectiveness

Courtney E Lamberton et al. Respir Care. .

Abstract

COPD is a common and lethal chronic condition, recognized as a leading cause of death worldwide. COPD is associated with significant morbidity and disability, particularly among older adults. The disease course is marked by periods of stability and disease exacerbations defined by worsening respiratory status resulting in a high burden of health care utilization and an increased risk of mortality. Treatment is focused on pharmacologic therapies, but these are not completely effective. Pulmonary rehabilitation (PR) represents a key medical intervention for patients with chronic respiratory diseases, including COPD. PR provides individualized and progressive exercise training, education, and self-management strategies through a comprehensive and multidisciplinary program. PR has been associated with improvement in exercise capacity, health-related quality of life, and dyspnea in patients living with COPD. Moreover, PR has been associated with improvements in hospital readmission and 1-y survival. In addition to the clinical benefits, PR is estimated to be a cost-effective medical intervention. Despite these benefits, participation in PR remains low. We will review the evidence for PR in each of these benefit domains among patients with stable COPD and in those recovering from a COPD exacerbation.

Keywords: COPD; COPD exacerbation; hospitalization; mortality; pulmonary rehabilitation.

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Conflict of interest statement

Dr Mosher discloses relationships with the Patient-Centered Outcomes Research Institute, American Lung Association, AstraZeneca, National Institutes of Health, COPD Foundation, and Wellinks. Dr Lamberton has disclosed no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Threshold value estimates: total cost per pulmonary rehabilitation session. *Assumes 36 sessions. ICER = incremental cost-effectiveness ratio; QALY = quality-adjusted life year; PR = pulmonary rehabilitation. From Reference 9, with permission.
Fig. 2.
Fig. 2.
Summary of benefits of pulmonary rehabilitation in COPD.
See this image and copyright information in PMC

References

    1. Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC. Chronic obstructive pulmonary disease surveillance–United States, 1971–2000. MMWR Surveill Summ 2002;51(6):1-16. - PubMed
    1. Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al. ; BOLD Collaborative Research Group. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007;370(9589):741-750. - PubMed
    1. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2015;2015(2):Cd003793. - PMC - PubMed
    1. Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2016;12(12):Cd005305. - PMC - PubMed
    1. Ryrsø CK, Godtfredsen NS, Kofod LM, Lavesen M, Mogensen L, Tobberup R, et al. . Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med 2018;18(1):154. - PMC - PubMed

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