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A study evaluating the economic impact of adopting home NIV as part of a multifaceted intervention program for severe chronic obstructive pulmonary disease (COPD) revealed positive and promising results for patients, providers and payers1.
Significant decreases in both hospital and payer costs and hospitalization rates for severe COPD1 patients were achieved in the Philips-sponsored study entitled, “Cost Savings from Reduced Hospitalizations with Use of Home Noninvasive Ventilation for COPD.”
COPD presents an increasing challenge to patients and healthcare systems. It’s a major cause of morbidity and mortality, the most common cause for readmissions, and is responsible for substantial increase in healthcare costs. In total, the economic burden of COPD is expected to be $50 billion by 20202. Read more
For COPD patients, staying active and improving exercise tolerance are important to reducing symptoms and risks such as disease progression and exacerbation events. However, the symptoms of COPD, such as breathlessness often make it difficult to exercise. Dr. Teofilo Lee-Chiong, pulmonologist and Chief Medical Liaison, Philips, shares insight on how to help your patients fight dyspnea and stay active.
Q: Why is exercise an important part of a COPD treatment regimen?
Dr. Lee-Chiong: In general, exercise is an important component of pulmonary rehabilitation. Increasing the duration or intensity of exercise could have a positive effect on the benefits of a rehabilitation program and improve the quality of life for COPD patients. Long-term physical activity has been shown to reduce the frequency of hospitalizations3 and exacerbations4.
COPD symptoms, such as breathlessness and exercise intolerance, make participating in everyday activities such as climbing a flight of stairs and even showering difficult for patients. These symptoms progress as the disease advances, leading to inactivity and muscle deconditioning. This can continue in a cycle leading to further inactivity, social isolation, and fear of undertaking any activities that could result in dyspnea.5
Improvements in exercise tolerance have been found to be linked with physiological changes such as improved muscle function, altered breathing pattern (higher tidal volume), and lower breathing frequency that leads to a reduced dead space to tidal volume ratio and thus to a lower ventilatory requirement for exercise.6, 7 With increased exercise tolerance patients have a better chance of being able to complete and enjoy daily activities.
ERS 2017 will take place in Milan, Italy, Sept 9-13. The event is catered to needs of all respiratory care professionals, from scientists to clinicians and allied health professionals.
Empowering patients to treat and manage their COPD symptoms; stay active and social; and adhere to their care plan is made easier with key tools and technologies.
Staying social and active
Exercise, completing every day activities and spending time with friends and family are all important to the health and wellbeing of COPD patients, but COPD symptoms make them all more difficult. Tools that can help patients maintain care at home and an active lifestyle include:
Respiratory muscle training
For COPD patients, the ability to stay active and healthy is linked to the strength of their breathing muscles and lunch capacity. Working out their respiratory muscles with Respiratory Muscle Training (RMT) helps strengthen key muscles that enables deeper breathing and more oxygen to enter their bloodstream8.
Improving air quality
While outdoor air quality is difficult to control, COPD patients can take steps to control and improve their indoor air quality. In addition to ensuring windows are sealed properly, keeping pets off beds and using natural cleaners, indoor air can be made healthier by using an air purifier that traps indoor air contaminants and continually monitors air quality.
COPD monitoring
Easy-to-use self-monitoring solutions give patients greater control of their therapy and confidence in their treatment through reliable measurements.
Remote viewing and tracking
Keeping your care team connected with patients and each other helps you optimize and customize care plans for every patient and appropriately prioritize evaluation and follow-up. Tracking and analyzing remote patient data also enables active patient engagement/self-management through personalized health surveys and, when using connected devices, provides automatic data transmission that gives care teams the data they need to intervene quickly.
Available now:
1 Coughlin, S., Lee-Chiong MD, T. (2017). “Cost Savings from Reduced Hospitalizations with Use of Home Noninvasive Ventilation for COPD.” Published. https://www.valueinhealthjournal.com/article/S1098-3015(16)30068-7/abstract
2 Murphy DO, T. (2016). “Is Variation on Following the GOLD Guidelines Provider Dependent?” Published. http://journal.publications.chestnet.org/article.aspx?articleid=2568785&resultClick=1
3 Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Anto JM. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study. Thorax. 2006;61(9):772-778.
4 Garcia-Aymerich J, Farrero E, Felez MA, et al. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003;58(2):100-105.
5Hardy, William, Jasko, Jeff. Philips Respironics. Evaluation of a portable positive pressure device to relieve dyspnea during exercise in COPD patients. Murrysville, PA: 2015, online.
6Casaburi R., Porszasz J. Burns MR, Carithers ER, Chang RSY, Cooper CB. Physiological benefits of exercise training in rehabilitation of severe COPD patients. Am J Respir Crit Care Med 1997; 155: 1541-1551.
7Casaburi R. Mechanisms of reduced ventilatory requirement as a result of exercise training. Eur Respir Rev 1995; 5: 15, 42-46.
8PhysiPedia, Respiratory muscle training. http://www.physio-pedia.com/Respiratory_Muscle_Training. Accessed 2 July 2015