Getting the rehabilitation message across: emerging barriers and positive health benefits

Abstract

The world's press frequently contains stories of failed rehabilitation attempts 1 by media personalities, and popular songs on this topic can galvanize strong views 2. Such events highlight the popularisation of a faulty view that rehabilitation offers only a marginal opportunity for benefit and as such should be avoided at all costs. It is unclear if such scepticism, reinforced by the media, impacts upon those with long-term illness and whether it limits, for example, what pulmonary and cardiac rehabilitation programmes have to offer. In a recent local Primary Care Trust chronic obstructive pulmonary disease (COPD) service evaluation report, patients voiced their concern over the term “rehab” 3 as they believe that there is stigma attached to the term. This previously unrecognised concern may form a new barrier to pulmonary rehabilitation programmes. Clearly, any such concern needs to be addressed as these are interventions of great benefit to our patients 4, 5. However as recruitment and retention of patients into rehabilitation programmes is not easy, as a specialty we need to reflect upon the terminologies we use and how best we “sell” or market these interventions to our patients. COPD represents a global health burden 6 and will move from being the 12th cause to the 5th cause of disability adjusted-life years lost by the year 2020 7. In the UK, >5% of all deaths have been attributed to COPD and up to one in eight emergency hospital admissions may be due to the condition 8. Patients who experience acute exacerbations of COPD have: 1) more frequent visits to the emergency department and hospitalisation 9, 10; 2) a more rapid decline in lung function 11; and 3) a reduced quality of life 12. Pulmonary rehabilitation, which contains elements of …