Pulmonary rehabilitation utilization in patients with chronic respiratory diseases: 2014–2019

Background: Chronic respiratory diseases are associated with significant disability and death. Pulmonary rehabilitation (PR) is recommended in the management of chronic respiratory diseases. There is limited population level data comparing PR utilization and completion among patients with chronic respiratory diseases. Methods: A retrospective, cross sectional analysis concerning PR use in adults residing in the U.S. with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), idiopathic pulmonary fibrosis (IPF), pulmonary hypertension, and bronchiectasis was conducted using the Merative™ MarketScan® Research Databases. PR use was identified using current procedural terminology (CPT) and healthcare common procedure coding system (HCPCS) codes. Demographics, comorbidities, oxygen use, medications, initiation and participation of PR by disease state were collected. Analysis involved chi-square tests and generalized estimating equations. Results: From 2014 to 2019, we identified 892,741 adults with chronic respiratory diseases and COPD was the most prevalent. PR initiation occurred in 2.3 % and annual participation ranged from 1.5 % to 1.7 %. The IPF group had the largest proportion of patients that initiated PR compared to other groups. Completion of ≥8 sessions was greatest for the group with IPF (60.8 %), followed by non IPF ILD (56.2 %), bronchiectasis (55.3 %), pulmonary hypertension (55.1 %) and COPD (53.9 %). Completion of ≥8 sessions was significantly greater for the IPF group compared to the COPD group, (p < 0.0001). Conclusion: PR was underutilized among individuals with chronic respiratory disease, however the group with IPF demonstrated the greatest proportion of PR initiation and completion compared with other groups.