Pulmonary rehabilitation: A regional perspective evidenced-based review

Moamary, Mohamed S Al; Alorainy, Hassan S; Al-Hajjaj, Mohamed S.

doi:10.4103/1817-1737.124408

Cited by 10 publications

(9 citation statements)

References 40 publications

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“…The lack of sensitivity of BMI for the monitoring of nutritional status has already been described by other authors [ 28 , 29 ], who highlighted the possibility of an erroneous perception of recovered nutritional status. The specific deficits of protein and micronutrients cannot be identified using BMI.…”

Section: Discussionmentioning

confidence: 83%

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Bacelo

Ramalho²,

Brasil³

et al. 2015

PLoS ONE

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The Brazilian Ministry of Health and the World Health Organization recommend dietary counseling for patients with malnutrition during tuberculosis treatment. Patients under tuberculosis therapy (infected and not infected with HIV) were followed-up to evaluate the effectiveness of dietary counseling. Objective: describe the nutritional status of patients with tuberculosis. Methods: an observational follow-up study over a 180-day period of tuberculosis therapy in adults was conducted. Subjects were assessed for body composition (using BMI, TSF and MUAC parameters), serum biomarkers and offered dietary counseling. The data obtained at each visit (D15, D30, D60, D90, D120, D150, and D180) were analyzed, showing trajectories over time and central tendencies each time. Results: at baseline, the mean age was 41.1 (±13.4) years; they were predominantly male, with income lower than a local minimum wage and at least six years of schooling. Patients showed predominantly pulmonary tuberculosis. At baseline, all patients suffered from malnutrition. The overall energy malnutrition prevalence was of 70.6%. Anemia at baseline was observed in both groups (63.2%), however, it was significantly more pronounced in the HIV+. At the end, energy malnutrition was reduced to 57.1% (42.9% of HIV- and 71.4% of the HIV+). Micronutrients malnutrition was evident in 71.4% of the HIV- patients and 85.7% of HIV+ patients at the end of tuberculosis therapy. Using BMI (≤18.5 kg/m2cutoff) as an index of malnutrition, it was detected in 23.9% of the HIV- and 27.3% of the HIV+ patients at baseline, with no evident improvement over time; using TSF (≤11.4mm as cutoff) or MUAC (≤28.5cm as cutoff), malnutrition was detected in 70.1% and 85.3% of all patients, respectively. Nevertheless, combining all biomarkers, at the end of follow-up, all patients suffered from malnutrition. Conclusion: Although with a limited number of patients, the evidence does not support that dietary counseling is effective to recover from malnutrition in our population.

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Section: Discussionmentioning

confidence: 83%

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Bacelo

Ramalho²,

Brasil³

et al. 2015

PLoS ONE

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“…This study is the first to assess the barriers to setting up a PR program in Saudi Arabia. [ 15 17 20 ] The study results show that only a very small percentage of the Saudi health care providers know what PR is. Hospitals capacity, trained health care providers, and funds were seen by the health care providers as the main barriers to setting up a PR program.…”

Section: Discussionmentioning

confidence: 97%

“…There is only one tertiary care center offering a PR program in the entire Saudi Arabia. [ 15 17 20 ] It is, however, possible that some private hospitals run PR programs, but they are often not well known by health care providers. It is very likely that barriers found in our study also apply to the rest of the Saudi Provinces because the Eastern Province is the largest and has a higher number of beds, funds, and health care providers.…”

Section: Discussionmentioning

confidence: 99%

Barriers for setting up a pulmonary rehabilitation program in the Eastern Province of Saudi Arabia

Alsubaiei¹,

Cafarella²,

Frith³

et al. 2016

Ann Thorac Med

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BACKGROUND:Pulmonary rehabilitation (PR) programs proven to be one of the most effective treatment options for respiratory diseases; yet, they are not well-established in hospitals in Saudi Arabia.AIM:To determine the main barriers for setting up PR programs in Saudi Arabia.METHODS:A cross-sectional study was conducted in the Eastern Province of Saudi Arabia. Health care providers involved in treatment of chronic obstructive pulmonary disease (COPD) patients were recruited from 22 general government hospitals. Data were collected using questionnaires: Full version if they had heard about PR before the study, and a short version if they had not heard about PR before.RESULTS:A total of 123 health care providers were recruited (physicians [n = 44], nurses [n = 49], and respiratory therapists/technicians [n = 30]). Only 3.2% of the recruited health care providers had heard about PR programs before. According to the health care providers, the main barriers for setting up PR programs were a lack of (1) hospital capacity (75.6%), (2) trained health care providers (72.4%), and (3) funds (48.0%). There were significant differences in barriers reported by the health care providers. Compared to physicians, nurses were more likely to nominate the PR costs as a barrier (18.0% vs. 38.8%; P < 0.05).CONCLUSION:There is a worrisome lack of knowledge regarding content and benefits of PR programs among Saudi health care providers treating COPD patients. These findings imply that improving awareness and increasing education of the health care providers regarding PR will be required before PR can be more widely implemented as an integral treatment modality for patients with COPD in Saudi Arabia.

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“… 16 , 37 Our data show that pulmonary rehabilitation programs were not available in the included hospitals, and to our best knowledge, only one military hospital is currently offering pulmonary rehabilitation in Saudi Arabia (Central province). 7 , 38 The number of patients with COPD who can access pulmonary rehabilitation in Saudi Arabia is therefore extremely low, especially compared to countries such as the United Kingdom in which 88% of hospitals offer pulmonary rehabilitation programs. 24 Barriers for setting up pulmonary rehabilitation programs in the Eastern province should be investigated, so that implementation of these programs can be facilitated.…”

Section: Discussionmentioning

confidence: 99%

Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a descriptive study

Alsubaiei¹,

Cafarella²,

Frith³

et al. 2015

COPD

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BackgroundCOPD is a leading cause of morbidity and mortality worldwide. The prevalence rate of COPD in the general Saudi population is estimated to be 2.4% and 14.2% among smokers. Not much is known about current health care services for patients with COPD in Saudi Arabia. The objective of this study was to determine the current care services for patients with COPD provided by government hospitals in the Eastern province of Saudi Arabia.MethodsA cross-sectional study was conducted in the Eastern province of Saudi Arabia. Directors of the Department of Internal Medicine from all 22 general government hospitals that are under the responsibility of the Ministry of Health or the Ministry of Higher Education in this region were asked to participate. Data were collected using a questionnaire.ResultsThe study results indicated that there are limited hospital facilities for patients with COPD: no respiratory departments in any of the included hospitals, no spirometry in 77.3% of the hospitals, no intensive care units in 63.7% of the hospitals, and no pulmonary rehabilitation program in any of the hospitals. Among the included 22 hospitals, 24 respiratory physicians, 29 respiratory therapists, and three physiotherapists were involved in COPD care.ConclusionIn conclusion, current care services provided by government hospitals in the Eastern province of Saudi Arabia for patients with COPD do not meet international recommendations for COPD management. Increased awareness, knowledge, and implementation of COPD guidelines by health care providers will most probably improve COPD management in Saudi Arabia. In addition, the government could improve dissemination of information about COPD management through national programs and by offering specific education regarding respiratory diseases.

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Pulmonary rehabilitation: A regional perspective evidenced-based review

Cited by 10 publications

References 40 publications

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Barriers for setting up a pulmonary rehabilitation program in the Eastern Province of Saudi Arabia

Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a descriptive study

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Pulmonary rehabilitation: A regional perspective evidenced-based review

Cited by 10 publications

References 40 publications

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients

Barriers for setting up a pulmonary rehabilitation program in the Eastern Province of Saudi Arabia

Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a&nbsp;descriptive study

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Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a descriptive study