Review Question - QID 109588

A 65-year-old man presents to the emergency department with shortness of breath. He was at home cleaning his yard when his symptoms began. The patient is a farmer and does not have regular medical care. He has smoked 2 packs of cigarettes every day for the past 40 years. The patient lives alone and admits to feeling lonely at times. His temperature is 99.5°F (37.5°C), blood pressure is 159/95 mmHg, pulse is 90/min, respirations are 19/min, and oxygen saturation is 86% on room air. On physical exam, you note a man in distress. A pulmonary exam reveals poor air movement, wheezing, and bibasilar crackles. A cardiac exam is notable for an S4 heart sound. The patient is started on appropriate therapy and his symptoms improve. Prior to discharge, he is no longer distressed when breathing and his oxygen saturation is 92% on room air. Which of the following interventions could improve mortality the most in this patient?