Cost-saving effect of supervised exercise associated to COPD self-management education program

Respir Med. 2011 Mar;105(3):377-85. doi: 10.1016/j.rmed.2010.10.002. Epub 2010 Oct 29.


Background: Although the benefits of comprehensive pulmonary rehabilitation have been demonstrated in patients with COPD, the effects of exercise sessions within self-management programs remain unclear. We hypothesized that 8 supervised exercise sessions incorporated in a 1-month self-management education program in COPD patients would be effective to improve health outcomes and to reduce direct medical costs after one year, compared to usual care.

Methods: In this randomized controlled trial, 38 moderate-to-severe COPD patients were assigned either to an intervention group or to a usual care group. The hospital-based intervention program provided a combination of 8 sessions of supervised exercise with 8 self-management education sessions over a 1-month period. The primary end-point was the 6-min walking distance (6MWD), with secondary outcomes being health-related quality of life (HRQoL)--using the St. George's Respiratory Questionnaire (SGRQ) and Nottingham Health Profile (NHP), maximal exercise capacity and healthcare utilization. Data were collected before and one year after the program.

Results: After 12 months, we found statistically significant between-group differences in favor of the intervention group in 6MWD (+50.5 m (95%CI, 2 to 99), in two domains of NHP (energy, -19.8 (-38 to -1); emotional reaction, -10.4 (-20 to 0)); in SGRQ-symptoms (-14.0 (-23 to -5)), and in cost of COPD medication (-480.7 € (CI, -891 to -70) per patient per year).

Conclusion: The present hospital-based intervention combining supervised exercise with self-management education provides significant improvements in patient's exercise tolerance and HRQoL, and significant decrease of COPD medication costs, compared to usual care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cost-Benefit Analysis
  • Exercise Therapy / economics*
  • Exercise Tolerance / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data
  • Patient Education as Topic / economics
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life / psychology
  • Self Care / economics*
  • Surveys and Questionnaires