Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence

Abstract

Rationale Several randomised controlled trials support the provision of early pulmonary rehabilitation (PR) following hospitalisation for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, there is little real-world data regarding uptake, adherence and completion rates. Methods An audit was conducted to prospectively document referral, uptake, adherence and completion rates for early posthospitalisation outpatient PR in Northwest London over a 12-month period. Results Out of 448 hospital discharges for AECOPD, 90 referrals for post-hospitalisation PR were received. Only 43 patients received and completed PR (9.6% of all hospital discharges) despite a fully commissioned PR service. Conclusions Despite the strong evidence base, there are poor referral and uptake rates for early outpatient PR following hospitalisation for AECOPD, with only a small proportion of the intended target population receiving this intervention.

Bedside Assessment of Quadriceps Muscle by Ultrasound after Admission for Acute Exacerbations of Chronic Respiratory Disease

“…These data demonstrate, on the basis of quadriceps size, no difference in mortality or efficacy of the intervention in any particular subgroup. It is unknown whether other interventions, such as postexacerbation pulmonary rehabilitation or other targeted therapies, would be more effective or more acceptable in patients with a better prognosis (i.e., those with larger muscle) (25)(26)(27).…”

Effects of Pulmonary Rehabilitation on Exacerbation Number and Severity in People With COPD

“…In addition the England and Wales national COPD audit programme, which includes data from both the acute hospital settings and primary care, reported that 31% of patients referred for rehabilitation did not attend the initial assessment, and 40% of those referred did not complete the programme 22,33 . A small proportion of individuals are offered pulmonary rehabilitation following an AECOPD but even fewer will take up a course 34 . While we are likely to have overestimated the number of eligible but not referred people in this dataset, as we cannot account for the main reasons people may not be eligible, our findings are in keeping with the UK pulmonary rehabilitation audit data 22 .…”

The knowledge level of chest physicians about the pulmonary rehabilitation topic

“…KOAH'lılarda PR'un fonksiyonel egzersiz performansına ve hastalığa bağlı sağlık durumuna katkısını gösteren birçok çalışma yayınlanmıştır [21,22]. KOAH alevlenme nedeniyle hastanede yatış sırasında veya hemen akabinde uygulanan PR programlarının çok yararlı ve maliyet etkin olduğu gösterilmiştir [20,23,24]. Ancak, KOAH alevlenme nedeniyle hastanede yatış sonrası PR'a sevk edilme ve uygulama oranları tüm dünyada hala çok düşük seyretmektedir [25][26][27].…”