Northwell Health’s Feinstein Institute for Medical Research has been awarded a $1.5 million grant from the Patient-Centered Outcomes Research Institute (PCORI) to study whether home-based pulmonary rehabilitation improves quality of life and decreases hospitalization in Hispanic patients with moderate to severe chronic obstructive pulmonary disease (COPD).
“Re-hospitalization is a huge burden for COPD patients and their families,” said Negin Hajizadeh MD, MPH, who is associate professor of medicine at Hofstra Northwell School of Medicine, in the division of pulmonary, critical care and sleep medicine at North Shore University Hospital, and the principal investigator of the study. “We want to find a way to bring a therapy we know works – pulmonary rehabilitation – to COPD patients who are most in need.”
“There is a great disparity in the services that are offered and utilized by Hispanic patients with COPD,” said Renee Pekmezaris, PhD, vice president of community health and health services research at Northwell Health, an associate professor of medicine and population health at the Hofstra Northwell School of Medicine and the co-principal investigator of the study. “It is difficult for Hispanic patients to gain access to pulmonary rehabilitation, which has shown to be critical for strengthening breathing muscles, learning how to manage the disease and enhancing quality of life. A growing number of studies have suggested that rehab reduces hospitalizations for pulmonary problems.”
Dr. Hajizadeh and Dr. Pemezaris aim to enroll 276 Hispanic COPD patients; half of whom will be referred to a standard pulmonary rehabilitation program and the others will receive pulmonary rehabilitation via telehealth in their home. The telehealth arm of the study will include a stationary exercise bike and a tablet that patients will use for their remote, online rehab sessions with a Spanish-speaking respiratory therapist. The therapist will go through exercises with at least four patients in their own homes at each session. They will be coached one-on-one using video on computer tablets.
The study will assess whether telehealth led to better outcomes, including reduced subsequent hospitalizations, compared to standard rehab program referrals, which many patients have difficulty accessing due to lack of insurance or finances for copayments, and difficulty with transportation.
In organizing the study, Northwell researchers teamed up with a local Hispanic couple with COPD. They have provided invaluable insights to the design of the study. The research team also includes an expert in outreach and community health, pulmonologists and a respiratory therapist with pulmonary rehab expertise, a senior biostatistician, an expert qualitative researcher and members of El Poder de Decidir, a community based organization in Queens, NY that empowers Hispanic people to make informed decisions about their health. “Working with patients and community leaders who have personal experience with managing COPD in the Hispanic community will ensure that the design is practical and acceptable to the people whose lives we are aiming to improve” says Dr. Hajizadeh. “We are excited to continue working with these partners as we now implement our study design.”
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Joe Selby, MD. “We look forward to following the study’s progress and working with the Feinstein Institute of Medicine at Northwell Health to share the results.”
The award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.
PCORI is an independent, nonprofit organization authorized by Congress in 2010. It’s mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.