By Charlotte LoBuono
Patients often need to be readmitted to the hospital after being discharged, and reducing this re-admittance rate is one way to cut healthcare costs. In fact, one in five patients returns to the hospital within 30 days of discharge, Huong Nguyen, a research scientist with Kaiser Permanente in California tells TheDoctor.
Nguyen and her colleagues recently looked at ways to reduce the rate of readmission among patients with chronic obstructive pulmonary disease (COPD) and found that exercise appears to help.
“Exercise... is one thing that COPD patients have control over, even when they have little control over other risk factors,” says Nguyen. “It was nice to see that patients can take action to reduce their readmission risk.”
Because the Kaiser system assesses exercise behavior at every outpatient visit, her team was able to use that data to see if physical activity was associated with risk of readmission among COPD patients.
The six thousand patients in the study had all been hospitalized with COPD. They were divided into three groups according to how active they were. Those who were deemed active got at least 150 minutes of physical activity per week. People who were insufficiently active exercised between one and 149 minutes per week, and people who were inactive did no exercise at all.
People in the most active group had a 34 percent lower risk of readmission within 30 days of discharge compared to inactive persons. Even those who were insufficiently active had a far lower risk of readmission versus those who were inactive. So even a little exercise can go a long way to keeping COPD patients out of the hospital and healthcare costs down.
“It is a misperception by a lot of people who have COPD, and clinicians as well, that if you have lung disease, you should not be exercising,” Nguyen says. “But exercise is the best thing for you.”
She advises patients to set small goals for themselves at first, maybe a few minutes a day, and increase that over time. Starting small is really important, because for a lot of folks who have been sedentary for so long, the idea of being physically active is kind of scary, Nguyen says.
Nguyen suggests patients find a walking buddy to help them stay motivated, or take some type of exercise class, if they prefer to exercise in a group setting. And ultimately, exercise should be fun, because that is the only way to stick with an exercise program over time.
It is also important for people to schedule physical activity — on a calendar — just as they would a doctor’s appointment, so that they do it regularly, she said.
COPD patients should ask their physician about the resources available to help them become more physically active. Hospitals or health plans may offer educational and exercise programs to which they can be referred.
In addition, pulmonary rehabilitation is recommended for COPD patients, so they should ask their provider about it. If these programs are unavailable, alternatives exist such as exercise classes at senior centers and the YMCA.
The study was published recently in the Annals of the American Thoracic Society.
April 17, 2014