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Building consensus for provision of breathlessness rehabilitation for patients with chronic obstructive pulmonary disease and chronic heart failure

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Title: Building consensus for provision of breathlessness rehabilitation for patients with chronic obstructive pulmonary disease and chronic heart failure
Authors: Man, WD
Chowdhury, F
Taylor, RS
Evans, RA
Doherty, P
Singh, SJ
Booth, S
Thomason, D
Andrews, D
Lee, C
Hanna, J
Morgan, MD
Bell, D
Cowie, MR
Item Type: Journal Article
Abstract: The study aimed to gain consensus on key priorities for developing breathlessness rehabilitation services for patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Seventy-four invited stakeholders attended a 1-day conference to review the evidence base for exercise-based rehabilitation in COPD and CHF. In addition, 47 recorded their views on a series of statements regarding breathlessness rehabilitation tailored to the needs of both patient groups. A total of 75% of stakeholders supported symptom-based rather than disease-based rehabilitation for breathlessness with 89% believing that such services would be attractive for healthcare commissioners. A total of 87% thought patients with CHF could be exercised using COPD training principles and vice versa. A total of 81% felt community-based exercise training was safe for patients with severe CHF or COPD, but only 23% viewed manual-delivered rehabilitation an effective alternative to supervised exercise training. Although there was strong consensus that exercise training was a core component of rehabilitation in CHF and COPD populations, only 36% thought that this was the ‘most important’ component, highlighting the need for psychological and other non-exercise interventions for breathlessness. Patients with COPD and CHF face similar problems of breathlessness and disability on a background of multi-morbidity. Existing pulmonary and cardiac rehabilitation services should seek synergies to provide sufficient flexibility to accommodate all patients with COPD and CHF. Development of new services could consider adopting a patient-focused rather than disease-based approach. Exercise training is a core component, but rehabilitation should include other interventions to address dyspnoea, psychological and education needs of patients and needs of carers.
Issue Date: 12-Apr-2016
Date of Acceptance: 3-Feb-2016
URI: http://hdl.handle.net/10044/1/31844
DOI: https://dx.doi.org/10.1177/1479972316642363
ISSN: 1479-9731
Publisher: SAGE Publications
Start Page: 229
End Page: 239
Journal / Book Title: Chronic Respiratory Disease
Volume: 13
Issue: 3
Copyright Statement: The final, definitive version of this paper has been published in Chronic Respiratory Disease by Sage Publications Ltd, All rights reserved. © SAGE Publications Ltd, 2016. It is available at: http://dx.doi.org/10.1177/1479972316642363
Sponsor/Funder: Imperial College Trust
National Institute for Health Research
Funder's Grant Number: N/A
N/A
Keywords: Breathlessness
COPD
consensus
heart failure
rehabilitation
Respiratory System
1102 Cardiovascular Medicine And Haematology
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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