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50 pulmonary rehab clinics required to meet COPD need

Prof Tim McDonnell, Consultant Respiratory Physician at St Vincent’s University Hospital, Dublin, said there was a “severe deficit” in the capacity available for pulmonary rehabilitation.

The full capacity in the system for patients requiring pulmonary rehabilitation post-exacerbation would only provide access for 10 per cent of patients. It would also not meet the needs of the vast numbers of patients experiencing ongoing dyspnoea from their COPD, Prof McDonnell stated.

“If you took all patients admitted to hospital each year with an exacerbation, that would be about 16,000 admissions, about 11,000 of which would be unique patients; that’s a minimum. You should be offering pulmonary rehabilitation to all of those and yet the total capacity when we went through what was available was just 1,200 patients. That’s only for patients who’ve had a recent exacerbation,” he said.

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Prof Tim McDonnell

Prof McDonnell was unable to put an exact figure on the number of clinics currently in operation, explaining that some work “year-round, while others do not”.

The HSE is examining the possibility of opening more clinics, but no funding has been confirmed to support the proposal to date, he said.

Ireland has the highest rate of hospital admission for COPD exacerbations in the OECD. 

Forthcoming national clinical guidelines on COPD are undergoing an economic evaluation and will focus on improving pulmonary rehabilitation capacity.

A collaboration between the National Clinical Programme and the RCPI is to launch this month, aims to improve COPD care through the introduction of new standards and training.

A pilot has been completed in two hospitals and it is hoped 20 hospitals will take part in the programme, which will run for 15 months.

The pilot in South Tipperary General Hospital resulted in a reduction in admission rates from 100 per cent to 22 per cent and a projected bed day saving of more than 1,700 per annum.

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