Leading Better Value Care
Local vignette – South Eastern Sydney LHD

Chronic obstructive pulmonary disease

Pulmonary rehabilitation – a clinician's perspective

By Renae McNamara

28 Apr 2021 Reading time approximately

What is important to know about your service?

Prince of Wales Hospital has implemented a novel pulmonary rehabilitation modular (PuReMod) program for pulmonary rehabilitation (PuRe) services. The program individualises the mode of PuRe exercise and education according to the patient’s preference and identified needs to improve the PuRe completion rate. Reaching and engaging the target population in PuRe is an important first step for people with chronic obstructive pulmonary disease (COPD) to achieve successful outcomes from rehabilitation.

What organisational model do you use?

Pulmonary rehabilitation.

Diagnostic testing
leads to
Exacerbation management
leads to
Ongoing care
leads to
Last year of life

What is special about the way care is delivered that is valuable for others to know?

Patients with COPD are referred to PuRe and attend a face-to-face assessment. Based on eligibility criteria, health and safety screening, and lung disease knowledge (using the lung information needs questionnaire), participants are:

  1. Offered a choice of one of three supervised group exercise training modes, twice weekly for eight weeks: hospital land (gym)-based, hospital water (pool)-based, or home-based telerehabilitation (virtual group using real-time videoconferencing).
  2. Allocated to tailored education modules, depending on assessed need.

A companion document describes options for organisational models in COPD. One option is a Respiratory Coordinated Care Program – this vignette describes the model from a local perspective.

How does it make a difference?

This program has the ability to offer different modes of evidence-based exercise training and different models of education delivery to personalise the rehabilitation program. Results from a study of 169 participants demonstrated a completion rate for PuReMod of 67% compared with 56% for traditional PuRe. Improvements in health outcomes and lung disease knowledge for PuReMod were similar to traditional PuRe.

What tips do you have for others?

  • Determine the main problem with referral, access, uptake or completion of the program.
  • Design a novel mode of delivery to address main problem/s - consider staff, referrers and patient preferences.
  • Evaluate program and clinical outcomes.

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