Pulmonary rehabilitation programmes in the UK: a national representative survey

Yohannes, Abebaw Mengistu; Connolly, Martin J.

doi:10.1191/0269215504cr736oa

Cited by 160 publications

(146 citation statements)

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“…Other questionnaires, such as the Hospital Anxiety and Depression Scale [46], Hopkins Symptom Check List [47] and Patient Health Questionnaire [48], quantify multiple dimensions of psychological function and provide a subscore for anxiety-related symptoms. Despite the important contribution that psychological manifestations such as anxiety make to the morbidity associated with COPD, the uptake of these instruments in clinical practice appears poor [49][50][51]. Specific threshold values have been established for some of these questionnaires, which permit those individuals at risk of exhibiting an anxiety-related disorder to be identified [45,46,48].…”

Section: Screening and Diagnosismentioning

confidence: 99%

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Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

226

142

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Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important.A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders.Randomised controlled trials indicate that exercise training and carefully selected pharmacological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechanisms that patients use. However, anxiety and depression are associated with dyspnoea, fatigue and altered sleep, all of which also occur in COPD.An understanding of the psychological history and coping mechanisms of patients and the role of anxiety and depressive reactions to illness may enable clinicians to reduce these symptoms and improve quality of life among patients with chronic obstructive pulmonary disease.KEYWORDS: Anxiety, chronic obstructive pulmonary disease, depression C hronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is not fully reversible [1]. In addition to the primary pulmonary pathology, the impact of secondary skeletal muscle dysfunction on exercise capacity and survival is well established [2,3]. Psychological impairments, ranging from feelings of depression and anxiety to full diagnostic mental disorders, although prevalent in this population, have received less interest. As COPD is incurable, therapeutic interventions aim to optimise function and slow disease progression [4]. Attention has focused predominantly on the effectiveness of strategies such as smoking cessation [5], longterm oxygen therapy (LTOT) [6,7], influenza vaccines [8], respiratory-specific pharmacological management [9], surgical options [10], conditioning of the peripheral muscles with graduated exercise training [11] and chronic disease selfmanagement strategies [12].Despite the prevalence of depression and anxiety and their impact on the morbidity associated with COPD, these psychological consequences of the disease are rarely addressed, at least in the respiratory medicine community. The purpose of the present review is to raise awareness among pulmonologists, general practitioners and allied health professionals to the secondary psychological impairment associated with COPD. Although anxiety and depression often coexist, they represent separate constructs [13]. Broader reviews of the psychological characteristics of patients with COPD are available [14]. ANXIETY Classification and diagnostic cr...

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Section: Screening and Diagnosismentioning

confidence: 99%

“…In addition, screening questionnaires may identify high-risk patients [48][49][50]. MULROW et al [98] systematically evaluated the usefulness of nine case-finding instruments in identifying patients with major depression.…”

Section: Screening and Diagnosismentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

226

142

View full text Add to dashboard Cite

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“…In that way, the benefits of PR can be extended to a substantially larger part of the COPD population, to reach even those with milder stages of disease. cluded in a UK survey that only 1% of the COPD population had access to a PR program [14]. These results are confirmed in a more recent Canadian study, where it was found that only 1.2% of the COPD population was able to follow a PR program [15].…”

mentioning

confidence: 60%

“…PR has proven to be the most effective treatment for COPD patients [4,5,11,12], but its use in daily practice is limited due to low availability and accessibility, high costs and short duration of administration [13][14][15][16][17]. When a program is provided where the elements of PR are integrated into a tailor-made program consisting of proper self-management, regular exercise and based on individualized targets, people can be managed in their home environment, while primary care providers are more involved and in the position to coach this process directly [41].…”

Section: Resultsmentioning

confidence: 99%

Potential benefits of integrated COPD management in primary care

Kruis

Chavannes

2016

Monaldi Arch Chest Dis

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Chronic obstructive pulmonary disease (COPD) represents a major and progressive cause of morbidity and mortality worldwide, resulting in an important financial and health burden in coming decades. Pulmonary rehabilitation (PR) has been proven to be the most effective treatment in all patients in whom respiratory symptoms are associated with diminished functional capacity or reduced quality of life. Nevertheless, despite wide recommendation and proven efficacy, the use of PR is limited in daily practice. Reasons for these include low accessibility and availability, high costs, and lack of motivation to continue a healthy life style after treatment. By contrast, it has been demonstrated that primary care patients can be reactivated by formulating personal targets and designing individualized treatment plans in collaboration with their general practitioner or practice nurse. Based on these personal plans and targets, specific education must be provided and development of self management skills should be actively encouraged. Ideally, elements of pulmonary rehabilitation are tailored into a comprehensive primary care integrated disease management program. In that way, the benefits of PR can be extended to a substantially larger part of the COPD population, to reach even those with milder stages of disease. Favorable longterm effects on exercise tolerance and quality of life in a number of studies have been demonstrated in recent years, but broad introduction in the primary care setting still needs further justification in the form of a proper cost effectiveness analysis.

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“…5 As has been demonstrated in the management of other chronic diseases such as diabetes, 6 the potential to influence outcomes of care exists when patients are in hospital for conditions other than their primary illness. Given the issues of access to PR in the community, 7,8 as well as the need to build capacity and improve quality of care within the health care system, it is important to consider that people enrolled in rehabilitation for conditions other than COPD may benefit from some aspects of PR while participating in non-pulmonary rehabilitation (NPR). However, little information is available on the prevalence of COPD among people enrolled in NPR.…”

mentioning

confidence: 99%

Prevalence and Characteristics of Patients with a Diagnosis of Chronic Obstructive Pulmonary Disease Participating in Non-Pulmonary Rehabilitation Programmes: A Brief Report

Janaudis-Ferreira

D’Souza

Brooks

et al. 2014

Physiotherapy Canada

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Purpose: To determine the prevalence of people with a diagnosis of chronic obstructive pulmonary disease (COPD) among those completing nonpulmonary rehabilitation (NPR) programmes and to describe their characteristics. Methods: Electronic data of participants who completed an in-patient rehabilitation programme between July 1, 2010, and July 1, 2012 were retrospectively reviewed. Data extracted were month and year of birth, sex, height, weight, referral source, admission and discharge dates, programme admitted to, reason for admission, most responsible health condition, number of co-morbidities, referral agency on discharge, and Functional Independence Measure (FIM) scores on admission and discharge. Results: The prevalence of COPD among participants who completed the NPR programmes was 7.5%. The most common reasons for admission were cardiac conditions (n ¼ 69, 20%), followed by post-unilateral hip replacement (n ¼ 40, 11%) and post-unilateral hip fracture (n ¼ 38, 11%). Patients were discharged after an average stay of 20 (SD 13) days. The mean FIM score was 91 (SD 11) at admission and 108 (SD 9) at discharge. Conclusions: The prevalence of a COPD diagnosis among participants in NPR programmes was 7.5%. COPD is a common comorbidity for people in rehabilitation programmes who have had amputations, have a cardiac condition, have undergone organ transplantation, or require complex care.Key Words: chronic obstructive pulmonary disease; prevalence; rehabilitation. RÉ SUMÉObjectif : É tablir la pré valence des personnes atteintes d'une MPOC chez celles qui effectuent un programme de ré adaptation non pulmonaire et dé crire leurs caracté ristiques. Mé thodes : Examen ré trospectif de donné es informatisé es au sujet de participants hospitalisé s ayant terminé un programme de ré adaptation entre le 1 er juillet 2010 et le 1 er juillet 2012. Les donné es extraites é taient les suivantes: mois et anné e de naissance, sexe, grandeur, poids, source de ré fé rence, date d'admission et date du congé , programme effectué , raison de l'admission, problè me de santé principal, nombre de comorbidité s, agence d'aiguillage au moment du congé , note de la mesure d'indé pendance fonctionnelle (MIF) à l'admission et au moment du congé . Ré sultats : La pré valence de MPOC chez les participants ayant terminé un programme de ré adaptation non pulmonaire é tait de 7,5%. La raison la plus fré quente de l'admission é tait un trouble cardiaque (n ¼ 69,20%), suivi d'une arthroplastie unilaté rale de la hanche (n ¼ 40,11%) et d'une fracture unilaté rale à la hanche (n ¼ 38,11%). Les patients ont obtenu leur congé aprè s un sé jour moyen de 20 (13) jours. La note moyenne de la MIF é tait de 91 (ET 11) à l'admission et de 108 (9) au moment du congé . Conclusions : La pré valence de MPOC chez les participants à un programme de ré adaptation non pulmonaire é tait de 7,5%. La MPOC est une comorbidité fré quente dans les programmes de ré adaptation destiné s aux personnes qui ont subi une amputation ou une greffe d'organe, qui sont aux p...

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Pulmonary rehabilitation programmes in the UK: a national representative survey

Cited by 160 publications

References 13 publications

Anxiety and depression in end-stage COPD

Anxiety and depression in end-stage COPD

Potential benefits of integrated COPD management in primary care

Prevalence and Characteristics of Patients with a Diagnosis of Chronic Obstructive Pulmonary Disease Participating in Non-Pulmonary Rehabilitation Programmes: A Brief Report

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