Pulmonary rehabilitation delivers substantial health benefits for those who complete treatment

Completing pulmonary rehabilitation (PR) reduces hospital admissions, length of hospital stay and mortality rates, reveals the latest report from the National COPD Audit Programme, led by the Royal College of Physicians, working closely with PCRS-UK and other respiratory and GP organisations.

The report reveals that:

• People who complete a PR programme are much less likely to be admitted to hospital:
  • Three quarters (76%) of people who completed a PR programme avoided hospital admission within six months after their initial assessment, compared to 62.1% who did not.
• PR reduces length of hospital stay:
  • People who were admitted to hospital and had completed a PR course spent only 4.8 days in hospital in six months compared with 9.6 days for those who did not complete the programme.
• Mortality is lower in people who complete PR:
  • Within three months, only 0.1% of people who had completed PR treatment had died compared to 1.6% of people who had not completed it.
  • Within six months, only 0.5% of patients who had completed PR treatment had died compared with 3.2% of patients who did not complete treatment.

Called Pulmonary Rehabilitation: Beyond Breathing Better, the report reviews patients’ hospital admissions and mortality following assessment for PR for 7,135 people across 195 English PR services.  

The report calls for healthcare providers and commissioners to be aware of the substantial health benefits of completing PR, and the variety of reasons that may lead to patients not completing PR, including transport and access issues, as well as other illnesses.  It recommends that PR providers should increase the convenience and acceptability of programmes.

Noel Baxter, PCRS-UK Chair says:  “As we anxiously anticipate the impact of COPD exacerbations on our health service this winter we have yet another reminder that this very high value intervention can make a difference. In primary care, we have a responsibility as individual health professionals and those who are commissioners to ensure that we implement these recommendations.”

Alex Woodward, respiratory physiotherapist, PCRS-UK Service Development Committee and Policy Committee member, says: “The results of this national audit highlight how integral pulmonary rehabilitation is in the care of patients with COPD and further strengthens the need for all appropriate patients to attend and complete it. Primary care providers and referrers need to work together to develop innovative ways to increase uptake and completion of pulmonary rehabilitation, particularly following a hospital admission.”

What you can do:

• Prioritise the offer of referral for PR to eligible patients during consultations and support patients to complete programmes wherever possible.
• Provide patients with clear written information about the benefits of attending and completing PR

What commissioners can do:

• Ensure that robust referral pathways for PR are in place and that PR programmes have sufficient capacity to assess and enrol all eligible people.
• Incentivise providers to enrol a higher proportion of patients discharged from hospital.

Read the COPD Pulmonary Rehabilitation report HERE