New Guidelines Indicate the Necessary Use of Pulmonary Rehabilitation in Patients With COPD
In a recently published set of Clinical Practice Guidelines by the American Thoracic Society (ATS), a panel of experts has strongly recommended that pulmonary rehabilitation (PR) be used in adults with stable chronic obstructive pulmonary disease (COPD).1
“A strong recommendation indicates that the committee is certain that the desirable consequences of a recommendation outweigh the undesirable consequences,” ATS Chief of Guidelines and Documents Kevin Wilson, MD, said in a press release.2
In 2019, more than 3 million deaths worldwide occurred due to COPD, making it the third leading cause of death among the global population, according to the World Health Organization.2 In the United States, it is estimated that approximately 30 million individuals live with COPD, and only 3% to 4% of patients (with Medicare) are prescribed PR treatment for their disease, despite its known benefits.2
To address the need for better care, the expert panel made up of multidisciplinary health care professionals crafted six research questions that addressed PR for specific patient groups including COPD, interstitial lung disease, and pulmonary hypertension. Additionally, the panel created models for PR delivery for clinicians to follow.1 The recommendations published addressed the following questions posed by the expert panel:
- Should adults with stable chronic obstructive pulmonary disease undertake pulmonary rehabilitation?
- Should adults with COPD undertake pulmonary rehabilitation following hospitalization for an exacerbation?
- Should adults with interstitial lung disease undertake pulmonary rehabilitation?
- Should adults with pulmonary hypertension undertake pulmonary rehabilitation?
- Should adults with chronic respiratory disease undertake telerehabilitation?
- Should adults with chronic respiratory disease undertake maintenance pulmonary rehabilitation?
“We hope that these Clinical Practice Guidelines for PR will be a call to action to clinicians to refer suitable patients to PR and encourage their participation in treatment, as well as foster pulmonary specialists’ communication with health care professionals in other disciplines (for example, primary care and cardiology) about the benefits of PR for patients,” lead guidelines editor Carolyn L. Rochester, MD, professor of medicine at the Yale University School of Medicine, said in a press release.2
- Rochester CL, Alison JA, Carlin B, et al. Pulmonary rehabilitation for adults with chronic respiratory disease: an official American thoracic society clinical practice guideline. Am J Respir Crit Care Med. Published online August 15, 2023. https://www.atsjournals.org/doi/abs/10.1164/rccm.202306-1066ST?role=tab
- Pulmonary rehabilitation earns strong recommendation in new clinical practice guideline. News release. American Thoracic Society; August 15, 2023. Accessed August 22, 2023.