Posted on 08/20/2023 8:30:47 PM PDT by ConservativeMind
Despite its effectiveness, pulmonary rehabilitation (PR) is underused and under-prescribed. The expert panel charged with developing guidance for practitioners is hopeful that the latest Clinical Practice Guideline from the American Thoracic Society will change that.
Posted online, the panel issued a "strong recommendation" for PR in adults with stable chronic obstructive pulmonary disease or COPD.
In addition, strong recommendations that are based upon moderate or high-quality evidence lay the groundwork for developing health care performance measures, which are used to determine clinicians' adherence to specific recommendations (such as referrals of suitable patients to PR).
In the U.S., an estimated 30 million Americans suffer from COPD. The rates of disease are made starker by the estimate of PR treatment: only 3–4% of Medicare patients with COPD have been prescribed the treatment, according to a 2019 study in the Annals of the American Thoracic Society. The reasons PR is rarely part of the treatment plan are varied and include a lack of knowledge on the part of both clinicians and patients, reimbursement issues, as well as health care disparity.
For adults with stable chronic obstructive pulmonary disease (COPD), we recommend participation in pulmonary rehabilitation (strong recommendation, moderate quality evidence).
Should adults with chronic obstructive pulmonary disease undertake pulmonary rehabilitation following hospitalization for an exacerbation?
For adults with COPD, we recommend participation in pulmonary rehabilitation following hospitalization for an exacerbation of COPD (strong recommendation, moderate quality evidence).
Should adults with interstitial lung disease undertake pulmonary rehabilitation?
For adults with interstitial lung disease, we recommend participation in pulmonary rehabilitation (strong recommendation, moderate quality evidence).
Should adults with pulmonary hypertension undertake pulmonary rehabilitation?
For adults with pulmonary hypertension, we suggest participation in pulmonary rehabilitation (conditional recommendation, low quality evidence).
(Excerpt) Read more at medicalxpress.com ...
I read through the entire post above and, in spite of mentioning pulmonary rehabilitation many times, it failed to define it once!
G
The Docs in my rural area are aware of rehab, but it’s just not available locally. The closest facility it an hours drive away.
When I had heart failure in 2017, the cardiologist I saw prescribed rehab for me, until I told him how far away I live.
Just plain old walking seems to be helpful for many things.
Having read the article, the part I found most interesting was Certainty of Evidence and my own personal evaluation of Doctors, lol.
High -High confidence that the estimated effect is close to the true effect
Moderate -Moderate confidence that the estimated effect is close to the true effect, but with a chance that the true effect is considerably different
Low -Low confidence in the estimated effect. Higher likelihood that the true effect is considerably different from the estimated effect
Very low -Very low confidence in the estimated effect. High likelihood that the true effect is considerably different from the estimated effect
Pulmonary Rehab is pretty much identical to cardiac rehab. It is supervised, structured, progressive exercises with pulse oximetry monitoring, and oxygen supplementation when indicated. It is generally done an hour, twice weekly for about 36 sessions.
Case in point: Nintedanib
https://pro.boehringer-ingelheim.com/us/products/ofev/
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