Lalmolda C, et al. – This study was designed not only to assess patient compliance with a chronic disease management (CDM) program incorporating home–based exercise training as the main component after a severe COPD exacerbation but also to determine its impacts on health care utilization in the following year. The data presented in this work showed a CDM program incorporating exercise training for COPD patients without limiting comorbidities after a severe exacerbation scores high compliance and lessens admissions in the year following after the intervention.

Methods

• For this investigation, COPD patients with a severe exacerbation were incorporated in a case-cohort study at admission.
• An intervention group took an interest in a nurse-supervised CDM program during the two months after discharge, comprising of home-based PR with exercise components directly supervised by a physiotherapist, while the rest of the patients followed usual care.

Results

• Results of this study suggested that 19 of the 21 members (90.5%) were compliant with the CDM program and were compared with 29 usual-care patients.
• Compliance with the program was related to statistically significant diminishments in admissions due to respiratory disease in the following year (median [interquartile range]: 0 [0–1] vs 1 [0–2.5]; P=0.022) and in days of admission (0 [0–7] vs 7 [0–12]; P=0.034), and multiple linear regression analysis confirmed the protective impact of the CDM program (β coefficient -0.785, P=0.014, and R²=0.219).