Introduction of the harmonised respiratory physiotherapy curriculum

Troosters, Thierry; Tabin, Nathalie; Langer, Daniël; Burtin, Chris; Chatwin, Michelle; Clini, Enrico; Emtner, Margareta; Gosselink, Rik; Grant, Kathleen M.; Inal-Ince, Deni̇z; Lewko, Agnieszka; Main, Eleanor; Mitchell, Sharon; Niculescu, Alexandra; Oberwaldner, Béatrice; Pitta, Fábio

doi:10.1183/20734735.0124-2019

Cited by 24 publications

(14 citation statements)

References 8 publications

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“…Australian physiotherapists are crucial to the delivery of exercise training programmes including PR, as well as providing therapies to increase sputum production, reduce work of breathing and improve overall ventilation. Respiratory physiotherapists in Europe also undertake extensive training in these areas as well as conducting and interpreting pulmonary function testing [ 53 ]. Physiotherapy services, as a first point of contact, have been shown to be effective in patients with musculoskeletal skeletal complaints [ 32 ] and a viable alternative to GP care.…”

Section: Discussionmentioning

confidence: 99%

The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

Pagano

McKeough

Wootton

et al. 2020

Pilot Feasibility Stud

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Background Chronic obstructive pulmonary disease (COPD) contributes significantly to mortality, hospitalisations and health care costs worldwide. There is evidence that the detection, accurate diagnosis and management of COPD are currently suboptimal in primary care. Physiotherapists are well-trained in cardiorespiratory management and chronic care but are currently underutilised in primary care. A cardiorespiratory physiotherapist working in partnership with general practitioners (GPs) has the potential to improve quality of care for people with COPD. Methods A prospective pilot study will test the feasibility of an integrated model of care between GPs and physiotherapists to improve the diagnosis and management of people with COPD in primary care. Four general practices will be selected to work in partnership with four physiotherapists from their local health district. Patients at risk of developing COPD or those with a current diagnosis of COPD will be invited to attend a baseline assessment with the physiotherapist, including pre- and post-bronchodilator spirometry to identify new cases of COPD or confirm a current diagnosis and stage of COPD. The intervention for those with COPD will involve the physiotherapist and GP working in partnership to develop and implement a care plan involving the following tailored to patient need: referral to pulmonary rehabilitation (PR), physical activity counselling, medication review, smoking cessation, review of inhaler technique and education. Process outcomes will include the number of people invited and reviewed at the practice, the proportion with a new diagnosis of COPD, the number of patients eligible and referred to PR and the number who attended PR. Patient outcomes will include changes in symptoms, physical activity levels, smoking status and self-reported exacerbations. Discussion If feasible, we will test the integration of physiotherapists within the primary care setting in a cluster randomised controlled trial. If the model improves health outcomes for the growing numbers of people with COPD, then it may provide a GP-physiotherapist model of care that could be tested for other chronic conditions. Trial registration ANZCTR, ACTRN12619001127190. Registered on 12 August 2019—retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

Pagano

McKeough

Wootton

et al. 2020

Pilot Feasibility Stud

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show abstract

“…Beyond palliative care training, integration of contemporary chronic breathlessness understandings and management earlier in the care trajectory of chronic conditions is recommended [5,47]. Accordingly, a recent European post-graduate respiratory physiotherapy curriculum includes dyspnoea-related knowledge, skills and attitudes [48] and inclusion of chronic breathlessness on the agendas of all such education initiatives is an important step.…”

Section: Gaps In Baseline Confidence Familiarity With and Attitudes mentioning

confidence: 99%

Attitude change and increased confidence with management of chronic breathlessness following a health professional training workshop: a survey evaluation

Johnston

Young

Kay³

et al. 2020

BMC Med Educ

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Background: Clinicians and people living with chronic breathlessness have expressed a need to better understand and manage this symptom. The aim of this study was to evaluate a 3-day health professional training workshop on the practical management of chronic breathlessness. Methods: Workshop design and delivery were based on current understandings and clinical models of chronic breathlessness management, principles of transformative learning, and included sessions co-designed with people living with breathlessness. Registrants were invited to complete pre and post-workshop surveys. Pre and 1-week post-workshop online questionnaires assessed familiarity and confidence about workshop objectives (0[lowest]-10[highest] visual analogue scale), attitudes and practices regarding chronic breathlessness (agreement with statements on 5-point Likert scales). Post-workshop, participants were asked to describe implementation plans and anticipated barriers. Baseline familiarity and confidence were reported as mean (SD) and change examined with paired t-tests. Pre-post attitudes and practices were summarised by frequency/percentages and change examined non-parametrically (5-point Likert scale responses) or using a McNemar test of change (binary responses). Results: Forty-seven of 55 registrants joined the study; 39 completed both pre and post-workshop questionnaires (35 female; 87% clinicians; median 8 years working with people with chronic breathlessness). Post-workshop, greatest gains in confidence were demonstrated for describing biopsychosocial concepts unpinning chronic breathlessness (mean change confidence = 3.2 points; 95% CI 2.7 to 4.0, p < 0.001). Respondents significantly changed their belief toward agreement that people are able to rate their breathlessness intensity on a scale (60 to 81% agreement) although only a minority strongly agreed with this statement at both time points (pre 11%, post 22%). The largest shift in attitude was toward agreement (z statistic 3.74, p < 0.001, effect size r = 0.6) that a person's experience of breathlessness should be used to guide treatment decisions (from 43 to 73% strong agreement).

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“…Two articles in that issue, one on over-and misdiagnosis of COPD [1] and the other one on over-and under-diagnosis of asthma [2], were among the top three articles that received the most attention last year (based on Altmetric scores). Another favourite with our readers was the article "Introduction of the harmonised respiratory physiotherapy curriculum" [3].…”

Section: Screening and Surveillance In Respiratory Medicinementioning

confidence: 99%

Screening and surveillance in respiratory medicine

Dobler

2020

Breathe

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Introduction of the harmonised respiratory physiotherapy curriculum

Cited by 24 publications

References 8 publications

The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

Attitude change and increased confidence with management of chronic breathlessness following a health professional training workshop: a survey evaluation

Screening and surveillance in respiratory medicine

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