Pulmonary rehabilitation program survey in Japan in 2014

Pulmonary rehabilitation (PR) is recognized as standard care for patients with chronic respiratory disease. It has been reported that PR programs in Europe and North America were more popular than in Japan and were more multidimensional. In addition, comprehensive programs including exercise training, education and psychological support were common in North America and Europe. However, PR programs in Tokyo were reported mainly to include chest physiotherapy and oxygen therapy. Recently, comprehensive PR programs have become popular in Japan, but there are no reports about current PR programs in Japan. We conducted a nationwide survey to characterize current PR programs in Japan. The survey instrument was an 18-item questionnaire sent in April 2014 to 872 institutions approved as teaching institutions by the Japan Respiratory Society.In total, 344 institutions responded (response rate: 39.4%). PR was conducted in 304 of them (87.9%). The most common form of the PR programs was inpatient. The main contents of the PR programs included breathing retraining (97.6%), aerobic exercise (95.5%), strength training (82.5%), education (89.7%) and activities of daily living training (69.9%). Only 25% of institutions had a follow-up program. Problems associated with the PR programs included lack of staff and lack of time to perform the programs. According to this survey, we concluded that PR programs were being conducted in the majority of teaching hospitals for respiratory medicine in Japan and the structure of these programs has become more comprehensive than in a previous survey. However, we identified problems of a lack of a follow-up program, a lack of staff and a lack of time to perform pulmonary rehabilitation programs.