Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: Fact or fiction?

Background Early pulmonary rehabilitation (PR), following hospitalisation for acute exacerbation of COPD (AECOPD), improves exercise capacity and health related quality of life (Man et al. 2004) and reduces hospital readmissions and mortality (Puhan et al. 2011). Despite the evidence, there is poor referral, uptake and completion rates for post-hospitalisation early PR. Aim To prospectively document referral, uptake, and completion rates for post-hospitalisation early PR in a Northwest London borough. Methods Data was collected between November 2011 and October 2012. Data was corroborated by medical notes, hospital coding data, and data collected by the COPD team and the local PR provider. Results Of 448 patients, 286 met the referral criteria for PR. Only 90 of the eligible patients (32%) were referred. Reasons for non-referral could not be ascertained reliably from medical records. 22 referred patients declined assessment; the remaining 68 patients were all assessed within 2 weeks of discharge. 59 patients started outpatient PR, with 44 completing (completion rate 75%). ![Figure][1] Conclusion Despite the strong evidence base, only a small proportion of eligible COPD patients receive early post-hospitalisation PR. Completion rates are in line with those seen with PR in stable patients. Further work is required to explore referrer and patient attitudes to post-hospitalisation PR. [1]: pending:yes