Pulmonary RehabilitationWhat are the barriers and facilitators for referral?

Emma Vincent

Workshop outline What are the guidelines for pulmonary

rehabilitation? Workshop task and feedback Overcoming the barriers for referral Suggesting facilitators for referring Reasoning behind patients exercising Summary

BTS guidelines on pulmonaryrehabilitation in adults 2013

Evidence statement:Exercise capacity improves with PR compared with usual care (Evidence level 1++)

Recommendation:PR should be offered to patients with COPD with a view to improving exercise capacity by a clinically important amount (Grade A)

What is Pulmonary Rehabilitation (PR)?

Pulmonary Rehabilitation (PR) is a programme of structured supervised exercise, education, and psychosocial support which is recommended by national and international guidelines in the management of patients with COPD.

Why refer? There is strong evidence that PR

improves exercise tolerance, reduces anxiety, and improves symptoms in patients with COPD.

Patients participation in PR reduces admissions to hospital for exacerbation of symptoms.

Time Out 1.Barriers to the referral to PR.

Think about why some health care professionals may not be referring.

Consider the reasons why patients may not accept an referral.

Time Out 2.What may some of the facilitators be for referral to PR?

Consider the processes we can use to help aid referral for professionals.

What strategies can we use to help patients understand the importance of PR?

Helping patients understand the link.PR will aid their walking and activities such as their shopping, gardening and playing with children/grandchildren

Increased physical functioning will encourage their ability to cope with gentle activities/hobbies

Nutshell Referral to PR for patients with COPD is

a crucial step in achieving the implementation of high-evidence guideline recommendation.

Problem solving at local and national level may enhance the rates of referrals and reduce the numbers of barriers.