COPD patients 'should be referred for rehab'
13th December 2017 – Referring patients with chronic obstructive pulmonary disease (COPD) for rehabilitation treatment can reduce hospital admissions and lower the chances of dying from the disease, a report has concluded.
The national audit by the Royal College of Physicians and the British Thoracic Society found that 76% of people who completed a pulmonary rehabilitation (PR) course avoided being admitted to hospital within 6 months of their initial assessment compared to 62.1% who did not.
It also found that people who were in hospital and who did not complete their PR course within 6 months of being assessed, spent twice as long in hospital compared to hospitalised people who did complete a course.
Bronchitis and emphysema
COPD describes a group of lung conditions that make it difficult to empty air out of your lungs because the airways have narrowed. Smoking is the main cause, with persistent bronchitis and emphysema two of the most common conditions.
COPD is the 5th biggest killer in the UK.
The lung damage that causes COPD cannot be reversed but there are treatments that can make breathing easier.
Exercise and self-care
A pulmonary rehabilitation course for people who are severely breathless consists of a physical exercise programme and information on how to look after your body and lungs and manage symptoms.
Courses – usually lasting 6 to 8 weeks – are delivered by health care professionals including physiotherapists, nurses, and occupational therapists.
The audit, 'Pulmonary Rehabilitation: Beyond Breathing Better', found that PR has substantial health benefits for those in England who complete the treatment. However, many people do not stay the course.
It also reveals that death rates from COPD are higher in people who do not complete a course of PR. Within 6 months, 3.2% of people had died compared to 0.5% who had finished their PR course.
'I felt fantastic'
Pat Goldacre had lived with COPD for 10 years before she was referred to PR by her GP in 2006. A former aerobic exercise class leader, her experience is cited in the audit. She says her symptoms improved from the first day: "My breathing was better, I felt great straight away.
"You know when you do an exercise class and you can feel it doing good to your body? That was how I felt. It was fantastic."
The audit calls for PR programmes to be convenient and flexible. They should include rolling programmes with different start dates and be held in venues that are easy to get to, it says.
'A win-win option'
Dr Lisa Davies, a consultant respiratory physician, and chair of the British Thoracic Society's Board of Trustees, comments in a statement: "The treatment is a real 'win-win' option – offering excellent clinical outcomes in terms of reduced hospital readmissions, shorter lengths of hospital stay and lower mortality rates, whilst also being a very efficient use of NHS resources.
"We encourage all clinicians to ensure they're referring patients for pulmonary rehabilitation where appropriate – and we urge commissioners to make sure there is sufficient service capacity in place to meet demand."