The HSE National Clinical Programme for Respiratory is continuing to roll out 34 community-based dedicated pulmonary rehabilitation teams around the country.
According to the HSE, this provision will help “empower” people living with chronic obstructive pulmonary disease (COPD) to improve their symptom management and decrease hospitalisations.
The HSE and National Clinical Programme for Respiratory ‘end-to-end model of care for COPD’ is supporting people in community and hospital settings, with the establishment of specialist teams in the community including respiratory integrated care teams.
Services that will be made available in the community include evidence-based interventions such as pulmonary rehabilitation, stated the HSE.
COPD is the most prevalent respiratory disease in Irish adults and is a major cause of morbidity and mortality. It is estimated that 380,000 people are living with COPD, yet only 110,000 are diagnosed. At least 1,500 patients die each year of this disease and over 15,000 patients are admitted to hospital. COPD has considerable impact on the quality of life of the patient, families, and carers. The course of the disease involves ongoing medical care and, in certain patients, results in frequent hospital admissions.
Ms Angela Ryan, Programme Manager, HSE National Clinical Programme for Respiratory, said: “As part of both the integrated care for chronic disease management being rolled out in GP clinics and the national respiratory model of care, patients with COPD and asthma are being actively monitored by their GP and practice nurse to improve management of their conditions. This programme facilitates care in the community, closer to home, and can facilitate referral to the local pulmonary rehabilitation team, based in the community.
“The pulmonary rehabilitation teams include dedicated teams of specialist physiotherapists and nurses. Pulmonary rehabilitation improves dyspnoea (breathlessness), health status and exercise tolerance in patients with stable COPD and reduces hospitalisation in patients who have had a recent exacerbation. It leads to a reduction in symptoms of anxiety and depression.
“Education and self-management are core components of pulmonary rehabilitation. Self-management education with a healthcare professional, improves health status and decreases hospitalisations and emergency department visits.
“Pulmonary rehabilitation is a comprehensive intervention based on thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, self-management intervention aiming at behaviour 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 behaviours,” explained Ms Ryan.
Pulmonary rehabilitation is strongly recommended in the management of patients with COPD by current national and international guidelines. It involves supervised classes, twice weekly for eight weeks and can be delivered in-person and online.
Ms Brenda Deering, Clinical Specialist Physiotherapist Pulmonary Rehab Co-ordinator, HSE, said: “Being one of the first respiratory physiotherapists to bring pulmonary rehabilitation from the hospital into the community has been a challenge but has also been immensely rewarding on both a personal and professional level. Exercise is the cornerstone to the success of pulmonary rehabilitation; prescribing individualised exercise programmes for patients with an underlying lung condition takes skill and expertise and is based on a thorough assessment. Once the assessment is complete, my challenge is to ask patients who may never have exercised before, to exercise in a breathing zone they are not initially comfortable with whilst making it both fun and educational. Seeing people build new friendships and improve their health and quality of life is what makes my work so enjoyable.”
Dr Mark O’Kelly, GP, Rialto Medical, said: “The experience in our practice has been that patients who have engaged in the community pulmonary rehab programmes have benefited greatly. They have a better understanding of their disease and are better equipped from a self-management perspective also. This means that they are having less flare ups of their disease and have improved symptom control also.”
A suite of COPD self-management tools are available for patients on HSE websites as well as from COPD Support Ireland:
COPD Support Ireland are available via www.copd.ie and the national COPD advice line can be contacted on 1800 83 21 46