Abstract Introduction Interstitial lung disease (ILD) is associated with progressive symptoms with hospitalizations reported in 34.7 % of patients in the Pulmonary Fibrosis Foundation registry (King CS et al. AJRCCM 2024). While respiratory related hospitalizations were associated with poor clinical outcomes, post-discharge use of pulmonary rehabilitation was not reported. In other chronic respiratory disorders, such as COPD, pulmonary rehabilitation after hospital discharge is associated with reduced health care use and improved patient outcomes (Jenkins AR, Thorax 2024). Yet, there is limited data concerning post-hospital discharge use of pulmonary rehabilitation in patients with ILD. Our aim was to examine the use of pulmonary rehabilitation at the population level in post discharge patients with ILD in the United States and assess the associated patient factors. Methods We used IBM MarketScan Research Database to identify adults (≥ 18 years) hospitalized with non-IPF ILD or IPF between 2014 and 2023. Inclusion was continuous enrollment for 12 months before admission and 3 months post-discharge. Pulmonary rehabilitation use was defined as identification of ≥ one claim within 3 months after hospital discharge. Patients with neuromuscular conditions or dementia were excluded. Patient demographics, disease state, comorbidities, oxygen prescriptions, and medication history were collected. Descriptive statistics and multivariable logistic regression were employed to identify factors associated with pulmonary rehabilitation participation. Results Among 12,238 eligible patients (mean age 63.1 ± 11.0 years; 50.4% male), 555 (4.5%) participated in pulmonary rehabilitation within 3 months of discharge. pulmonary rehabilitation participation was higher in the IPF group (11.1%) compared to non-IPF ILD group (3.8%) (p 0.0001). Greater pulmonary rehabilitation participation was observed in males, prior oxygen prescription, antifibrotic use, immunosuppressive therapy, pulmonary rehabilitation use in prior 12 months and lung transplantation/assessment in prior twelve months. In a multivariable logistic regression, male sex was associated with greater likelihood of pulmonary rehabilitation participation (OR 1.30; 95% CI 1.08-1.57). A lower likelihood of pulmonary rehabilitation participation was associated with a new post-discharge prescription for supplemental oxygen (OR 0.37; 95% CI 0.29-0.49), no participation in pulmonary rehabilitation in the previous twelve months (OR 0.19, 95 % CI 0.15-0.25), and absence of lung transplantation in the preceding twelve months (OR 0.22; 95% CI 0.16-0.30). Previous prescriptions for antifibrotics or immunosuppressive therapy were not associated with pulmonary rehabilitation participation. Conclusion Pulmonary rehabilitation utilization after hospital discharge for patients with non-IPF ILD and IPF was low, and male sex was associated with greater use. This abstract is funded by: None
Singh et al. (Fri,) studied this question.