Preventing hospital admissions for COPD: role of physical activity
- Institute for Lung Health, Department of Respiratory Medicine and Thoracic Surgery, University Hospitals of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK; mike.morgan@uhl-tr.nhs.uk
There is increasing evidence that non-pharmacological interventions including physical activity may prevent hospital admissions for COPD.
A hospital admission or readmission for an exacerbation of chronic obstructive pulmonary disease (COPD) is bad news for everyone. For the patient it may signal the beginning of the terminal phase of the illness. For the health services it is a significant component of the cost of care for a condition that is increasingly burdensome. In recent years knowledge has been growing about the important role of the exacerbation in the deteriorating progress of COPD. The last few years of life with COPD may be characterised by repeated episodes of illness culminating in hospital admission. Exacerbations only lead to hospital admission in about 16% of cases, but their increasing frequency is associated with declining state of health.1
In UK hospitals emergency inpatient admission is the largest component of the total cost of respiratory disease to the NHS that amounts to over £2.5 billion.2 In recent years attention has focused on reducing the cost and impact of hospital admissions for COPD. The emphasis of the strategy to date has been on admission avoidance and early supported discharge schemes.3–5 These have had some success in curtailing admissions and reducing lengths of hospital stay, and are beginning to be introduced more widely into clinical practice. Contrary to popular perception, COPD is not a stable condition and there are inevitably day to day variations in both symptoms and ability to function. The periodic episodes of worsening are known as exacerbations, although a precise agreed definition is lacking. However, the meaning of the term is generally understood and a working appreciation of the impact of these events is becoming clear. Not all episodes of exacerbation lead …
