Pulmonary Rehabilitation

Did you know a “magic pill” currently exists that dramatically improves breathlessness, tolerance to physical activity and patient quality of life, while reducing frightening exacerbations and trips to the doctor or ER? But the “magic pill” is not a pill at all, or any medication for that matter…it is Pulmonary Rehabilitation.

Many people diagnosed with COPD are prescribed long-term inhaled medications designed to marginally improve lung function and reduce the likelihood of experiencing exacerbations. But even if patients dutifully take their medications as prescribed, many begin to experience declining efficacy over time, and either cease taking the medication or hop from one prescribed medication to another, in a frustrating, expensive experiment that never delivers sustained improvements in symptoms or quality of life.

The reason why prescribed maintenance medications rarely provide lasting benefit to most patients is that they do absolutely nothing to address one of the most important underlying causes of breathlessness related to COPD…deconditioning. Every patient with COPD tends to limit their physical activity to avoid breathlessness. Ironically, some patients are actually instructed by their physician to limit activities that cause them breathlessness. So, a patient with COPD, whose lung function is already compromised by their condition, rapidly grows more fragile and susceptible to breathlessness as their physical fitness declines. This phenomenon is known as the Deconditioning Cycle:

The only treatment clinically proven to provide lasting benefits in reduced breathlessness, improved tolerance to physical activity and greater quality of life, is Pulmonary Rehabilitation.

Pulmonary Rehabilitation (“PR”) is a multi-disciplinary intervention program offered by a select number of healthcare institutions around the country, and has been clinically proven to improve patient symptoms and quality of life, while reducing exacerbations and unexpected healthcare utilization. PR traditionally comprises three treatment elements: customized rehabilitative exercise, self-management education and social and behavioral support. And though PR has consistently showed improved patient outcomes in dozens of clinical trials over the past several decades, it sadly remains out of reach for the vast majority of the 13 million people living with COPD in the U.S. That is because the way traditional PR is approved, delivered, and reimbursed in this country limits its accessibility to only about one in ten patients diagnosed with COPD.

A patient has to be lucky enough to: 1) go to a physician aware of PR and willing to prescribe it, 2) qualify for coverage, 3) be able to afford the 20% co-pay [mandated by CMS, totaling over $1,000 out of pocket per patient], 4) live within proximity of one of the few approved facilities in the country, 5) have a reliable mode of transportation for the twice-a-week appointments over 8-12 weeks, and 6) have the flexibility to attend between 20-36 appointments over a 3-month period, in addition to all of their other scheduled healthcare appointments.

But even for these lucky patients, the temporary nature of traditional PR limits its long-term effectiveness. Some programs offer post-program (“Maintenance”) therapy, but CMS doesn’t cover this benefit, and patients who struggled to attend the 20+ classes during the three-month primary treatment often discontinue attending due to schedule conflicts, unreliable transportation or an inability to afford long-term, continued treatment. Sadly, these patients who enjoyed dramatic improvement in their symptoms and quality of life during the program begin to decondition within just a few months. In clinical studies, most patients return to their pre-program health status within 6-9 months of concluding their PR program.

We think it is a tragedy that effective treatment exists for people living with COPD, but that it isn’t accessible to most, and isn’t sustainable for any. Click here to learn how ModoSpira solves these problems.