Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence
- Sarah E Jones1,2,
- Stuart A Green3,
- Amy L Clark4,
- Mandy J Dickson2,
- Ann-Marie Nolan2,
- Clare Moloney2,
- Samantha S C Kon1,
- Faisal Kamal2,
- Joy Godden1,
- Cathy Howe3,
- Derek Bell3,
- Sharon Fleming1,
- B Mimi Haselden2,
- William D-C Man1,4
- 1NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, Harefield, UK
- 2Respiratory Outreach Team and Department of Respiratory Medicine, The Hillingdon Hospital, London, UK
- 3NIHR CLAHRC for Northwest London, Imperial College, London, UK
- 4Harefield Pulmonary Rehabilitation Unit, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UK
- Correspondence to Sarah Jones, Department of Respiratory Medicine and Pulmonary Rehabilitation, Harefield Hospital, Hill End Road, Harefield UB9 6JH, UK;
- Received 19 July 2013
- Accepted 23 July 2013
- Published Online First 14 August 2013
Rationale Several randomised controlled trials support the provision of early pulmonary rehabilitation (PR) following hospitalisation for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, there is little real-world data regarding uptake, adherence and completion rates.
Methods An audit was conducted to prospectively document referral, uptake, adherence and completion rates for early post-hospitalisation outpatient PR in Northwest London over a 12-month period.
Results Out of 448 hospital discharges for AECOPD, 90 referrals for post-hospitalisation PR were received. Only 43 patients received and completed PR (9.6% of all hospital discharges) despite a fully commissioned PR service.
Conclusions Despite the strong evidence base, there are poor referral and uptake rates for early outpatient PR following hospitalisation for AECOPD, with only a small proportion of the intended target population receiving this intervention.