Abstract
Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-reducing, psychosocial, and health economic benefits for patients with chronic respiratory diseases, yet it is underutilized worldwide. Insufficient funding, resources, and reimbursement; lack of healthcare professional, payer, and patient awareness and knowledge; and additional patient-related barriers all contribute to the gap between the knowledge of the science and benefits of PR and the actual delivery of PR services to suitable patients. The objectives of this document are to enhance implementation, use, and delivery of pulmonary rehabilitation to suitable individuals worldwide. Members of the American Thoracic Society (ATS) Pulmonary Rehabilitation Assembly and the European Respiratory Society (ERS) Rehabilitation and Chronic Care Group established a Task Force and writing committee to develop a policy statement on PR. The document was modified based on feedback from expert peer reviewers. After cycles of review and revisions, the statement was reviewed and formally approved by the Board of Directors of the ATS and the Science Council and Executive Committee of the ERS. This document articulates policy recommendations for advancing healthcare professional, payer, and patient awareness and knowledge of PR, increasing patient access to PR, and ensuring quality of PR programs. It also recommends areas of future research to establish evidence to support the development of an updated funding and reimbursement policy regarding PR. The ATS and ERS commit to undertake actions that will improve access to and delivery of PR services for suitable patients. They call on their members and other health professional societies, payers, patients, and patient advocacy groups to join in this commitment.
Highlights
Pulmonary rehabilitation (PR) has demonstrated physiological, symptomreducing, psychosocial, and health economic benefits in multiple outcome areas for patients with chronic respiratory diseases [1–8, 10–12, 15–49]
PR remains grossly underutilized worldwide [15, 50]; it is frequently not included in the integrated care of patients with chronic respiratory disorders and is often inaccessible to patients
A substantial gap exists between knowledge regarding the science and benefits of PR [11, 12, 15] and the actual delivery of PR services [15, 50]
Summary
Pulmonary rehabilitation (PR) has demonstrated physiological, symptomreducing, psychosocial, and health economic benefits in multiple outcome areas for patients with chronic respiratory diseases [1–8, 10–12, 15–49]. PR, as defined in the 2013 Official ATS/ERS Statement, is “a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors” [1, 12]. It emphasizes stabilization and/or reversal of extrapulmonary manifestations and comorbidities of chronic respiratory disease as well as the importance of behavior change.
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