Evidence map›Paper›PMID 30417670›Full record

ArticleAnnals of the American Thoracic Society2019

Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries.

Kerry A Spitzer, Mihaela S Stefan, Aruna Priya, Quinn R Pack, Penelope S Pekow, Tara Lagu, Victor M Pinto-Plata, Richard L ZuWallack, Peter K Lindenauer

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the American Thoracic Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 103 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
103citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04946708 nacompletednot on this mapstarted 2021, after this paper: background citation

Using Technology to Engage Patients With Interstitial Lung Disease (ILD) in a Home a Home Exercise Program.

TypeinterventionalSponsorUniversity of ManitobaRan2021 to 2022Enrolled14ConditionsInterstitial Lung DiseaseArmsExercise program (virtual/remote)
NCT05562037 nacompletednot on this mapstarted 2022, after this paper: background citation

Stepped Care vs Center-based Cardiopulmonary Rehabilitation for Older Frail Adults Living in Rural MA

TypeinterventionalSponsorPeter Lindenauer, MDRan2022 to 2025Enrolled139ConditionsAngina, Stable, Congestive Heart Failure, Chronic Obstructive Pulmonary DiseaseArmsStepped Care
3 · Its place in the literature

Who cites it

103 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. RuralEuropean respiratory review : an official journal of the European Respiratory Society · 2026
    Pooled it
  3. Equity in pulmonary rehabilitation delivery: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
  4. Pooled it
  5. Guideline
  6. Pooled it
  7. Efficacy of Repeating Pulmonary Rehabilitation in People with COPD: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2022
    Pooled it
  8. Telerehabilitation for chronic respiratory disease.The Cochrane database of systematic reviews · 2021
    Pooled it
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Article
  16. Review
  17. Article
  18. Who Enrolls After Referral to Virtual Pulmonary Rehabilitation? A Descriptive Comparison.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026
    Article
  19. Article
  20. Article

43 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Kerry A Spitzer1 Institute for Healthcare Delivery and Population Science and.ORCID 0000-0001-8371-0312
Mihaela S Stefan1 Institute for Healthcare Delivery and Population Science and.
Aruna Priya1 Institute for Healthcare Delivery and Population Science and.
Quinn R Pack1 Institute for Healthcare Delivery and Population Science and.
Penelope S Pekow1 Institute for Healthcare Delivery and Population Science and.
Tara Lagu1 Institute for Healthcare Delivery and Population Science and.
Victor M Pinto-Plata5 Division of Pulmonary and Critical Care Medicine, Baystate Medical Center, Springfield, Massachusetts.
Richard L ZuWallack6 Saint Francis Hospital and Medical Center, Hartford, Connecticut; and.
Peter K Lindenauer1 Institute for Healthcare Delivery and Population Science and.

Funding

A mixed methods study to analyze the use of pulmonary rehabilitation following hospitalization for COPD, and to identify effective strategies for increasing rates of participationR01HL133046 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI LINDENAUER, PETER KYLE · 2017 to 2020
$2.6M
Defining Optimal Clinical Strategies for Critically Ill Heart Failure PatientsK01HL114745 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI LAGU, TARA C · 2013 to 2017
$721k
Identifying Effective Strategies to Improve Participation in Cardiac Rehabilitation after an Acute Cardiac HospitalizationK23HL135440 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI PACK, QUINN RUSSELL · 2017 to 2020
$697k
Research and Mentoring in Comparative Effectiveness and Implementation ScienceK24HL132008 · NHLBI · BAYSTATE MEDICAL CENTER, INC. · PI LINDENAUER, PETER KYLE · 2016 to 2020
$574k
NHLBI NIH HHS K01 HL114745NHLBI NIH HHS K23 HL135440NHLBI NIH HHS K24 HL132008NHLBI NIH HHS R01 HL133046
6 · The paper itself

Abstract

rationaleCurrent guidelines recommend pulmonary rehabilitation (PR) after hospitalization for a chronic obstructive pulmonary disease (COPD) exacerbation, but little is known about its adoption or factors associated with participation.

objectivesTo evaluate receipt of PR after a hospitalization for COPD exacerbation among Medicare beneficiaries and identify individual- and hospital-level predictors of PR receipt and adherence.

methodsWe identified individuals hospitalized for COPD during 2012 and recorded receipt, timing, and number of PR visits. We used generalized estimating equation models to identify factors associated with initiation of PR within 6 months of discharge and examined factors associated with number of PR sessions completed.

resultsOf 223,832 individuals hospitalized for COPD, 4,225 (1.9%) received PR within 6 months of their index hospitalization, and 6,111 (2.7%) did so within 12 months. Median time from discharge until first PR session was 95 days (interquartile range, 44-190 d), and median number of sessions completed was 16 (interquartile range, 6-25). The strongest factor associated with initiating PR within 6 months was prior home oxygen use (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.39-1.59). Individuals aged 75-84 years and those aged 85 years and older (respectively, OR, 0.70; 95% CI, 0.66-0.75; and OR, 0.25; 95% CI 0.22-0.28), those living over 10 miles from a PR facility (OR, 0.42; 95% CI, 0.39-0.46), and those with lower socioeconomic status (OR, 0.42; 95% CI, 0.38-0.46) were less likely to receive PR.

conclusionsTwo years after Medicare began providing coverage for PR, participation rates after hospitalization were extremely low. This highlights the need for strategies to increase participation.

Indexed as

AgedAged, 80 and overDisease ProgressionFemaleHospitalizationHumansMaleMedicarePatient Acceptance of Health CarePulmonary Disease, Chronic ObstructiveSocial ClassUnited Stateschronic obstructive pulmonary diseasehospitalizationMedicarerehabilitation

Identifiers

PMID30417670
PMCPMC6344454

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.