Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

Abstract

Introduction

Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden.

Materials and methods

Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year.

Results

In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals.

Conclusion

Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2017

Publication date (Electronic): 08 June 2017

Volume: 12

Pages: 1695-1704

Affiliations

[1 ]Department of Respiratory Medicine, School of Medical Sciences

[2 ]Medical Programme, School of Medical Sciences

[3 ]Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro

[4 ]Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

[5 ]Department of Epidemiology and Public Health, University College, London, UK

[6 ]Department of Medical Sciences, Respiratory, Allergy and Sleep Research

[7 ]Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden

Author notes

Correspondence: Josefin Sundh, Department of Respiratory Medicine, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden, Tel [phone], Fax [phone], Email josefin.sundh@ 123456oru.se

Article

Publisher ID: copd-12-1695

DOI: 10.2147/COPD.S135111

PMC ID: 5473485

Copyright statement: © 2017 Sundh et al. This work is published and licensed by Dove Medical Press Limited

License:

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Categories

Subject: Original Research