People who have chronic obstructive pulmonary disease (COPD) frequently reduce their level of activity because of the uncomfortable symptoms of breathlessness that can occur on any exercise. This inactivity results in progressive de-conditioning and a vicious cycle begins to develop, where breathlessness occurs at ever-lower levels of activity. The purpose of pulmonary rehabilitation is to break this cycle, supporting individuals to increase their activity levels and learn more about how to manage their condition successfully. Pulmonary rehabilitation, which is typically delivered by a multi- disciplinary team, aims to address the multisystem effects of COPD on individuals and their families through a programme of exercise and education.
British and international guidelines for COPD reinforce the importance of pulmonary rehabilitation as a core component in the treatment of COPD, rather than as an optional extra. Despite good evidence for its benefits and cost-effectiveness, its availability has frequently been limited. In addition, a lack of understanding of its potential benefits, among health care professionals and patients, may sometimes have limited uptake even when services are available.
Recent BTS guidelines, issued in 2013, suggest that all health care professionals who manage COPD and make referrals should have a basic understanding of the benefits of pulmonary rehabilitation and what such programmes entail.
This resource, which is based on a typical case scenario, is offered at an advanced level and includes five assessment questions to support your continuing professional development. Complete the resource to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.
Aims and Objectives
On completion of this resource you should have an understanding of:
British Thoracic Society. BTS Guideline for Pulmonary Rehabilitation in Adults, 2013 https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/pulmonary-rehabilitation-guideline/
NICE CG101. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care (Update), 2010. Available at: www.nice.org.uk/cg101 Accessed May 2014
Department of Health. An outcomes strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England, 2011 www.gov.uk/government/publications/an-outcomes-strategy-for-people-with-chronic-obstructive-pulmonary-disease-copd-and-asthma-in-england
Department of Health. COPD Commissioning Toolkit: Pulmonary Rehabilitation service specification, 2012 www.gov.uk/government/publications/commissioning-toolkit-for-respiratory-services
Further education and training
Pulmonary rehabilitation is a core component of COPD management and is therefore considered as part of all COPD diploma and degree level courses in addition to one day workshops provided by Education for Health. For further information please see:
COPD eLearning Degree Module https://www.educationforhealth.org/shop.php/courses/117/copd
COPD eLearning Diploma Module
COPD eLearning Diploma Module (Stirling)
Essentials of COPD Workshop