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Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care
Örebro University, School of Medical Sciences. Department of Respiratory Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Medical Programme, School of Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences.
Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0001-6328-5494
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2017 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 12, p. 1695-1704Article in journal (Refereed) Published
Abstract [en]

Introduction: Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden.

Materials and methods: Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year.

Results: In primary care, nurse- based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals.

Conclusion: Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd. , 2017. Vol. 12, p. 1695-1704
Keywords [en]
multidisciplinary, asthma/COPD nurse, physiotherapist, occupational therapist, nutritionist, counselor
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-58797DOI: 10.2147/COPD.S135111ISI: 000402968500002PubMedID: 28652722Scopus ID: 2-s2.0-85020823895OAI: oai:DiVA.org:oru-58797DiVA, id: diva2:1128525
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy Association
Note

Funding Agencies:

County councils of the Uppsala-Orebro Health Care region

Bror Hjerpstedts Foundation  

Örebro Society of Medicine  

Region Örebro County through ALF (Avtal om Läkarutbildning och Forskning) 

Available from: 2017-07-26 Created: 2017-07-26 Last updated: 2018-07-20Bibliographically approved

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Sundh, JosefinHasselgren, MikaelMontgomery, Scott

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