Pulmonary

Rehabilitation
What 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 pulmonary
rehabilitation 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.