Pulmonary Rehabilitation in Canada: A Report from the Canadian Thoracic Society COPD Clinical Assembly

Camp, Pat G.; Hernández, Paul; Bourbeau, Jean; Kirkham, Ashley; Debigaré, Richard; Stickland, Michael K.; Goodridge, Donna; Marciniuk, Darcy; Road, Jeremy; Bhutani, Mohit; Dechman, Gail

doi:10.1155/2015/369851

Cited by 95 publications

(81 citation statements)

References 15 publications

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“…The non-standardised academic training of these healthcare professionals is a crucial aspect of the problem [27]. Important educational projects are ongoing across Europe and North America in effort to fill this gap [28,29].…”

Section: Pulmonary Rehabilitation Across Europe: Present and Futurementioning

confidence: 99%

Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement

et al. 2016

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Section: Pulmonary Rehabilitation Across Europe: Present and Futurementioning

confidence: 99%

Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement

et al. 2016

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“…Chronic lower respiratory disease (the majority consisting of COPD) is the fourth leading cause of death in Canada 6. Furthermore, COPD is the most common cause of chronic disease hospitalization in Canada 7. Studies suggest that the Aboriginal population of Canada has a higher incidence of COPD and a greater burden of disease compared to the non-Aboriginal Canadian population 8,9.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of COPD among Aboriginal peoples in Canada: a cross-sectional study

Bird

Moraros

Mahmood

et al. 2017

COPD

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BackgroundCOPD among Aboriginal peoples in Canada is a major public health concern. This study was conducted in order to determine the prevalence and association between certain risk factors and COPD among the 35-year-old or older Aboriginal peoples in Canada.MethodsThis is a cross-sectional study. It uses data from Statistics Canada’s Aboriginal Peoples Survey (APS), 2012. It consists of 8,117 self-identified Aboriginal peoples, aged 35 years old or older from all Canadian provinces and territories. The study outcomes centered on evaluating the prevalence and associated factors of COPD.ResultsThis study found that 6.80% of the participants self-reported having COPD. Results of the logistic regression analysis show that COPD was significantly higher among daily smokers (odds ratio [OR], 2.28; 95% confidence interval [95% CI], 1.65–3.14), aged 55 years or older (OR, 3.04; 95% CI, 2.14–4.30), who earned $5,000–$9,999 per annum (OR, 4.21; 95% CI, 2.39–7.41) and needed health care over the past 12 months and did not receive it (OR, 1.83; 95% CI, 1.27–2.65).ConclusionThe findings of our study show that COPD is strongly associated with Aboriginal peoples, who are older, smoke, have a low socioeconomic status (SES) and do not have access to health care when needed. Clinicians, health care professionals, medical/public health organizations, researchers and patients will greatly benefit from additional research in this common, serious and often overlooked disease among Aboriginal peoples in Canada.

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“…Another example of non-pharmacological management being neglected is access and referral to pulmonary rehabilitation (PR). According to a 2015 survey of PR in Canada, 16 despite an increase in the number of programs and patients enrolled since the previous survey in 2005, PR capacity has not kept pace with demand, with only 0.4% of eligible Canadians with COPD having access. 16 When asked, physicians who are regularly seeing COPD patients say that only 16% of their patients are referred to PR.…”

Section: Improving Symptom Burden and Preventing Exacerbations In Copmentioning

confidence: 99%

“…According to a 2015 survey of PR in Canada, 16 despite an increase in the number of programs and patients enrolled since the previous survey in 2005, PR capacity has not kept pace with demand, with only 0.4% of eligible Canadians with COPD having access. 16 When asked, physicians who are regularly seeing COPD patients say that only 16% of their patients are referred to PR. 17 This is in contrast with the 34% of high-risk cardiac patients who have been referred to cardiac rehabilitation programs in Ontario.…”

Section: Improving Symptom Burden and Preventing Exacerbations In Copmentioning

confidence: 99%

CTS position statement: Pharmacotherapy in patients with COPD—An update

Bourbeau

Bhutani

Hernández

et al. 2017

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

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RATIONALE: Since the last published Canadian Thoracic Society (CTS) COPD guideline in 2007 and the 2008 update -highlights for primary care, many new clinical trials have challenged COPD treatment practices. The current Canadian position statement provides the reader with an update on pharmacotherapy of patients with COPD as reviewed by the CTS. OBJECTIVES: The objectives of this position statement are: 1) to summarize the literature on topics relevant to the pharmacological therapy of patients with stable COPD; and 2) to provide clinical guidance with evidence-based recommendations and expert-informed key messages for the pharmacological therapy for patients with stable COPD. METHODS: The authors systematically reviewed the relevant literature focusing on randomized controlled trials and when available, systematic reviews of randomized controlled trials. The proposed key messages, based on scientific evidence and expert-informed opinion, were agreed upon by a majority consensus. MAIN RESULTS: There is typically a significant delay in seeking medical care by patients with dyspnea, often waiting until symptoms affect the performance of activities of daily living. The diagnosis of COPD requires spirometry to confirm the presence of airflow obstruction in any patient presenting with symptoms and/or risk factors of COPD. An effective management plan for individuals with COPD should include: smoking cessation, vaccination and education. A number of non-pharmacological treatments are available for COPD patients with symptoms to improve outcomes such as self-management with coaching from a health care professional; pulmonary rehabilitation; supplemental oxygen in selected patients; and surgery.Current pharmacotherapy for COPD has been shown to alleviate symptoms and prevent exacerbations and related complications such as hospital admissions. In symptomatic patients with stable COPD not having or having infrequent exacerbation, treatment should be started with inhaled LAMA or LABA monotherapy, and if experiencing persistent or increased dyspnea, exercise intolerance, and/or reduced health status despite use of monotherapy, patients should be considered for treatment "step up" with an inhaled LAMA plus LABA dual therapy. In this situation, the use of a single inhaler would be preferred to simplify the treatment regimen and minimize the cost. In patients with stable COPD experiencing exacerbations despite the use of LAMA or LABA monotherapy, treatment "step up" with inhaled LAMA plus LABA dual therapy should be considered unless a patient has concomitant asthma (Asthma/COPD overlap (ACO)). There has been recent interest in using biomarkers to identify patients who are more likely to respond to ICS. Most of the studies have demonstrated that high blood eosinophils could be valuable to predict an increase response in terms of reduction of exacerbation rate when treated with combination ICS/LABA; there is still uncertainty about the exact cut-off level of blood eosinophils having potential therapeutic value. If a pa...

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Pulmonary Rehabilitation in Canada: A Report from the Canadian Thoracic Society COPD Clinical Assembly

Cited by 95 publications

References 15 publications

Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement

Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement

Prevalence and associated factors of COPD among Aboriginal peoples in Canada: a cross-sectional study

CTS position statement: Pharmacotherapy in patients with COPD—An update

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