Patients with COPD who underwent pulmonary rehabilitation in Turkey: prevalence, distribution, and mortality

Abstract

Background: Pulmonary rehabilitation (PR) is an effective, evidenced-based treatment. Despite its proven effect, it is still underused.The aim of this study was to present the number of patients with chronic obstructive pulmonary disease (COPD) who underwent PR,general mortality percentages, the rate of patients prescribed PR by pulmonologists, and the distribution of institutions where PR wasperformed between 2008 and 2016 in Turkey.Materials and methods: The documents were obtained from Turkish Institution of Social Insurance. Ages, sexes, and numbers ofpatients with COPD who underwent PR between 2008 and 2016 were recorded. The number of patients with COPD who had beenprescribed PR by physicians and the type of hospitals in which these patients underwent PR were identified. The general annual andthe general total mortality rates between 2008 and 2016 among patients with COPD who underwent PR in 2008 were also determined.Results: The mean age ranges of patients with COPD who underwent PR were 67.4 ± 12.3 to 72.0 ± 13.2 years, and 62.2% (n =60,852) of patients were male. The number of patients increased progressively from 3,214 to 18,664. The rate of patients prescribed PRprograms between 2008 and 2016 was between 0.32% and 0.59% among all registered patients with COPD. Between 52.0% and 94.8%(5,488/10,549 and 16,792/17,707 patients, respectively) of the programs were prescribed by a pulmonologist, and 62.9% (n = 62,613)of patients received PR in secondary public hospitals. The general annual mortality rates were between 6.2% and 11.1% (115/1,855 and358/3,214 patients) in patients who underwent PR in 2008, and the general total mortality rate was 52.8% (1,696/3,214 patients) overthe 9-year period in the same patient group.Conclusion: PR was still an underutilized approach in Turkey between 2008 and 2016. The awareness of PR should be increased in ourcountry. In order to achieve this, we think that PR should be within the scope of health policies.