Pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: An audit of referral and uptake

Abstract

BACKGROUND: Successful pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) is dependent on timely and appropriate referral by health professionals, as well as adequate uptake and completion rates by patients. METHODS: A retrospective medical record audit was conducted on 183 in-patients, 133 day-cases and 532 respiratory outpatients (representing 50% of respiratory OPD clinics) in two academic teaching hospitals in Dublin. The audit period covered from 1st October to 31st December 2012. The audit tool was informed by the British Thoracic Society’s audit tool. The inclusion/ exclusion criteria of the Health Service Executive (HSE) Model of Care for Pulmonary Rehabilitation, was applied, in addition to a record of the patient being referred for PR assessment. The aim was to identify referral, uptake and PR completion rates over the 3-month period. RESULTS: From 183 confirmed COPD cases, 98 (54%) people met the HSE Model of Care criteria for PR, while 39 (21%) were not functionally limited by the disease. 23 (12%) were considered not suitable for PR. Approximately half (n = 50) of the eligible population were referred for PR assessment. However, after six months, only 7 people had completed a programme. CONCLUSIONS: The results of this audit confirm similar work in that referral to PR was adequate but timely uptake by patients remains poor. Low uptake has implications for the effectiveness of PR at reducing mortality rates and hospital readmission rates.