Palliative Rehabilitation Improves Health Care Utilization and Function in Frail Older Adults with Chronic Lung Diseases

Neo, Han-Yee; Yap, Chun Wei; Teo, L Di; Lee, Liang-Tee; Tan, Hong-Weng; Xu, Huiying; Hum, Allyn; Abisheganaden, John

doi:10.1016/j.jamda.2021.05.031

Cited by 10 publications

(3 citation statements)

References 48 publications

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“…Physical function and exercise capacity are major predictors of patient health outcomes, especially for those with advanced lung disease in a transplant program. Although the impact of PC in supporting patient function, independence and exercise capacity has been poorly studied, there are several integrative models of PC and rehabilitation demonstrating improvements in dyspnea, 6MWT, HRQL and healthcare utilization [58,59 ▪▪ ]. Understanding the role of PC in supporting patients trying to maintain or improve their functional capacity is an exciting area for discovery, not only for transplant medicine but all patients with chronic lung disease.…”

Section: Future Directionsmentioning

confidence: 99%

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

Rozenberg,

Andrawes,

Wentlandt

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Palliative care (PC) in lung transplantation is increasingly acknowledged for its important role in addressing symptoms, enhancing functionality, and facilitating advance care planning for patients, families, and caregivers. The present review provides an update in PC management in lung transplantation. Recent findings Research confirms the effectiveness of PC for patients with advanced lung disease who are undergoing transplantation, showing improvements in symptoms and reduced healthcare utilization. Assessment tools and patient-reported outcome measures for PC are commonly used in lung transplant candidates, revealing discrepancies between symptom severity and objective measures such as exercise capacity. The use of opioids to manage dyspnea and cough in the pretransplant period is deemed safe and does not heighten risks posttransplantation. However, the integration of PC support in managing symptoms and chronic allograft dysfunction in the posttransplant period has not been as well described. Summary Palliative care support should be provided in the pretransplant and select peri-operative and posttransplant periods to help support patient quality of life, symptoms, communication and daily function.

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Section: Future Directionsmentioning

confidence: 99%

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

Rozenberg,

Andrawes,

Wentlandt

2024

Current Opinion in Pulmonary Medicine

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“…However, patients with cachexia meet the GLIM criteria [167] for malnutrition related to chronic disease with inflammation Sarcopenia "A progressive and generalised skeletal muscle disorder that involves the accelerated loss of muscle mass and function" [169] EWGSOP 2 criteria [169] Muscle approach was attributed in part to appropriate assessment and stratification based on needs, shared care agreements across specialist and primary care services. In addition, a prospective cohort study of an inpatient integrated palliative rehabilitation programme in 100 people with chronic respiratory disease (majority with frailty) found that the intervention was associated with increased pharmacological treatment of anxiety and depression [187]. Although subsequent impact on patient-reported psychological symptoms was not measured, this approach illustrates how a structured comorbidity schema for screening and monitoring common coexisting conditions (including anxiety and depression) could increase offers of appropriate treatment.…”

Section: Description Criteriamentioning

confidence: 99%

European Respiratory Society statement on frailty in adults with chronic lung disease

et al. 2023

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Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine, however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a pre-requisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work.This European Respiratory Society Statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies), and identification of evidence gaps to inform future priority areas of research. Frailty is under-represented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.

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“…H.Y. Neo et al [23] examined the impact of 6-month palliative rehabilitation (functional rehabilitation with early palliative care) on medical care and functioning of frail older adults with chronic lung diseases, among which COPD (89 %), interstitial lung disease (54 %) and bronchiectasis (28 %) were most commonly identified. The authors estimated the number of hospital readmissions, length of hospital stay, number of emergency department visits, 6-minute walking distance and Modified Barthel Index (MBI).…”

mentioning

confidence: 99%

Peculiarities of pulmonary rehabilitation in patients with chronic respiratory diseases in palliative and hospice care (review)

Raznatovska

Петренко

2023

ТБ

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Pulmonary rehabilitation is an interdisciplinary program of care for patients with chronic respiratory disorders, created individually and aimed at physical and social indicators and autonomy optimizing. Physical therapists in an interdisciplinary palliative care team are key to the success of pulmonary rehabilitation for palliative patients, focusing on the physical functioning.Objective — to review the data from literature references regarding the characteristics and usage frequency of pulmonary rehabilitation for patients with respiratory diseases who require palliative and hospice care, and to specify respiratory diseases in palliative care patients for which pulmonary rehabilitation is currently used. As a result of the literature review, it was established that pulmonary rehabilitation in patients with chronic respiratory diseases who require palliative and hospice care is aimed at improving pulmonary symptoms (shortness of breaths) and functional status, reducing the intensity of accompanying symptoms, even in the late stages of the disease, which ultimately contributes improving the quality of life and survival of patients, reducing the burden on those who care for them. But access to physical (pulmonary) rehabilitation for patients with chronic respiratory diseases who need palliative and hospice care, is currently not routine in practice and not used enough around the world, unfortunately. It was found that today pulmonary rehabilitation in palliative patients is used only for chronic obstructive pulmonary diseases, interstitial lung diseases, cystic fibrosis, sarcoidosis, idiopathic pulmonary fibrosis and bronchiectasis. At the same time, the literature does not describe the use of physical therapy methods, including pulmonary rehabilitation, in patients with bronchial asthma who require palliative treatment. Pulmonary rehabilitation in patients with chronic respiratory diseases who require palliative and hospice care is a relevant and effective method of treatment, but needs wider implementation in the modern health care system.

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Palliative Rehabilitation Improves Health Care Utilization and Function in Frail Older Adults with Chronic Lung Diseases

Cited by 10 publications

References 48 publications

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

European Respiratory Society statement on frailty in adults with chronic lung disease

Peculiarities of pulmonary rehabilitation in patients with chronic respiratory diseases in palliative and hospice care (review)

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