Characterization of pulmonary rehabilitation programs in Canada in 2005.

BACKGROUND Pulmonary rehabilitation (PR) is recognized as the prevailing standard of care for patients with chronic respiratory conditions. National surveys of PR programs provide important information regarding the structure, content and organization of these programs. OBJECTIVE To conduct a national survey to characterize adult PR across Canada, in terms of program distribution, utilization, content and outcome measures. METHODS A cross-sectional descriptive study in which questionnaires were mailed to PR programs connected with hospitals or identified through the Canadian Lung Association was performed. RESULTS Of the 98 PR programs identified, over 90% of patients in the programs had chronic obstructive pulmonary disease (COPD) and 57% of the programs were outpatient. Inpatient programs accounted for only 10% of the total. The main program components included supervised lower extremity strength (77%), cycle (72%) and treadmill (70%) training, education (75%) and breathing retraining (68%). Over 80% of patients completed their programs and 90% of patients were enrolled in a follow-up component. Physical therapists, dieticians, respiratory therapists and respirologists were the most commonly identified health care providers. The most commonly used outcome measures were the 6 min walk test and disease-specific quality of life questionnaires. CONCLUSION There were similarities in program format, content, staffing, follow-up and funding among Canadian PR programs. The marked shortfall between the national PR capacity and the prevalence of COPD meant that only 1.2% of the COPD population had access to PR.

[1]  D. Dillman Mail and internet surveys: The tailored design method, 2nd ed. , 2007 .

[2]  Y. Lacasse,et al.  Pulmonary rehabilitation for chronic obstructive pulmonary disease. , 2002, The Cochrane database of systematic reviews.

[3]  Y. Lacasse,et al.  A Canadian, multicentre, randomized clinical trial of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease: rationale and methods. , 2005, Canadian respiratory journal.

[4]  A. Yohannes,et al.  Pulmonary rehabilitation programmes in the UK: a national representative survey , 2004, Clinical rehabilitation.

[5]  D. Brooks,et al.  State of the Art Compendium: Canadian Thoracic Society recommendations for the management of chronic obstructive pulmonary disease. , 2004, Canadian respiratory journal.

[6]  A. Iqbal,et al.  Interpreting COPD prevalence estimates: what is the true burden of disease? , 2003, Chest.

[7]  J. Izquierdo,et al.  The burden of COPD in Spain: results from the Confronting COPD survey. , 2003, Respiratory medicine.

[8]  J. Bourbeau,et al.  The burden of COPD in Canada: results from the Confronting COPD survey. , 2003, Respiratory medicine.

[9]  D. Brooks,et al.  Trends in the epidemiology of COPD in Canada, 1980 to 1995. COPD and Rehabilitation Committee of the Canadian Thoracic Society. , 1999, Chest.

[10]  D. Brooks,et al.  Pulmonary rehabilitation programs in Canada: national survey. , 1999, Canadian respiratory journal.

[11]  R. Zuwallack,et al.  Pulmonary rehabilitation - 1999 , 1999 .

[12]  Alison E. Ries Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based guidelines. ACCP/AACVPR Pulmonary Rehabilitation Guidelines Panel. American College of Chest Physicians. American Association of Cardiovascular and Pulmonary Rehabilitation. , 1997, Chest.

[13]  J. Hodgkin,et al.  National pulmonary rehabilitation survey. Update. , 1995, Journal of cardiopulmonary rehabilitation.

[14]  J. Hodgkin,et al.  National pulmonary rehabilitation survey. , 1988, Respiratory care.