CLINICAL IMPACT OF PULMONARY REHABILITATION USING OBJECTIVE AND SUBJECTIVE ASSESSMENTS

Abstract

Introduction: Pulmonary rehabilitation (PR) is an effective, appropriate intervention in patients with chronic obstructive pulmonary disease (COPD) and other related pulmonary disorders. Objective: Determination of PR's effect on healthcare utilization and quality of life through comparison of PR vs. non-PR groups. Parameters evaluated: number of hospital admissions (NOA), length of stay (LOS), activities of daily living/social functioning (DASF), psychological functioning (PF) and sexual functioning (SF). Methodology: 66 participants (39 PR, 27 non PR) with a diagnosis of chronic stable respiratory system impairment. Participant eligibility: non-smoking, pulmonary function studies within past year showing DLCO, FVC or FEV1 values < 60% of normal, Pulmonary Function Status Scale (PFSS) completed initially and repeated at 3 and 6 month intervals. PR group participated in a 12-week/24-session pulmonary rehabilitation program. The Performance Improvement Department at Mercy Medical Center obtained and evaluated data on NOA and LOS throughout the study for both PR and non-PR groups. Hospitalizations analyzed were related to respiratory morbidity (DRG 87, DRG 88). Results: Comparison showed: In PR group DASF increased 9.68%; PF increased 4.49%; SF increased 7.7% and total score increased 6.94%. Non-PR group DASF decreased 6.34%; PF decreased 1.76%; SF decreased 11.02% and total score decreased 4.04%. Outcomes for NOA and LOS: 3 of 39 (7.7%) of PR group were hospitalized with ALOS of 3.66 days. 6 of 27 (22.3%) non-PR group were hospitalized with an ALOS of 3.92 days. Conclusion: Results showed DASF change to be the only statistically significant area when comparing groups. However, when analyzing data in terms of percent increase/decrease we find the PR group increased scores in all areas of the PFSS and had a lower NOA rate per patient. The non-PR group showed decreased scores in all areas of the PFSS and had a higher NOA rate per patient. This suggests that PR does have a positive effect on quality of life for people with COPD and other pulmonary disorders.