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Study: 2 in 5 older adults with COPD lack access to beneficial treatment

Researchers say that while rehabilitation can improve the condition of COPD patients, services appear to be widely underused. Photo by kalhh/Pixabay
Researchers say that while rehabilitation can improve the condition of COPD patients, services appear to be widely underused. Photo by kalhh/Pixabay

May 18 (UPI) -- Nearly two in five older adults with COPD lack access to needed pulmonary rehabilitation services, an analysis presented Tuesday during the American Thoracic Society's 2021 conference found.

Just under 40% of Medicare beneficiaries with chronic obstructive pulmonary disease, or COPD, live more than 10 miles away from the nearest pulmonary rehabilitation clinic, the data showed.

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For nearly 15%, the closest clinic offering these services, which include exercise and educational programs designed to improve lung function, is more than 25 miles away.

Overall, the researchers found that one in four Medicare beneficiaries with COPD lives in small towns or rural areas with, on average, one pulmonary rehab clinic per 4,300 beneficiaries with COPD.

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"Pulmonary rehabilitation provides significant improvement in quality of life, functional capacity and also the number of hospitalizations due to COPD," study co-author Dr. Gargya Malla told UPI in an email.

"Yet, it is not utilized completely," said Malla, a researcher in epidemiology at the University of Alabama at Birmingham.

COPD, a lung disorder that causes chronic shortness of breath and difficulty breathing, affects more than 24 million adults in the United States, many of whom are current or former smokers, according to the American Lung Association.

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Studies have shown that pulmonary rehabilitation, a program of specialized exercises for people with COPD, provides significant improvement in quality of life and lung function, Malla and her colleagues said.

However, the treatment is used by a fraction of those with the condition, based on recent estimates.

For this study, Malla and colleagues Sandeep Bodduluri, Vivek Sthanam, Dr. Gulshan Sharma and Dr. Surya P. Bhatt identified nearly 10.3 million Medicare beneficiaries age 65 and older who were diagnosed with COPD between 1999 and 2018.

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The United States has 1,696 pulmonary rehabilitation centers, which the researchers matched against beneficiary ZIP codes, they said.

Just under 62% of Medicare beneficiaries with COPD live within 10 miles of a pulmonary rehabilitation center, while 73% reside within 15 miles of one.

Eighty-seven percent of beneficiaries have a pulmonary rehabilitation clinic within 25 miles of their homes, the researchers said.

In metropolitan areas, 73% of beneficiaries with COPD live within 10 miles of a pulmonary rehabilitation center, compared with 17% of those small towns and rural areas.

Previous research has indicated that people who live more than 10 miles from a pulmonary rehabilitation center are less than half as likely to use the treatment than those who live closer.

Potential solutions to issues of access and distance include the use of tele-rehabilitation services and expansion of home-based and Web-based pulmonary rehab services, the researchers said.

"People with COPD should make themselves aware about pulmonary rehabilitation and discuss their options and available resources with their healthcare provider," Malla said.

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