Pulmonary Rehabilitation "The forgotten treatment" for patients with COPD

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease affecting more than 6.1% of smokers over the age of 40 in New Zealand. If you have been diagnosed with COPD and have symptoms such as breathlessness, fatigue, anxiety and depression that affect your everyday life, then pulmonary rehabilitation is likely to benefit you. If unsure then ask your GP about this free service offered in the community by Auckland City Hospital and their community partners; The Laura Fergusson Trust.

Pulmonary Rehabilitation is a free 8 week group programme for patients with chronic lung diseases (such as COPD) who have developed physical and emotional symptoms which affect their everyday lives and limit their function.

It is a comprehensive program that has many benefits such as improving adherence to other treatments, decreasing frequency and severity of your symptoms (including breathlessness) and helping you to manage your condition more effectively. It will improve your mood and motivation and decrease your dependency on others around you by increasing your participation and independence through exercise and other self management strategies.

Pulmonary Rehabilitation is now medically considered "The Treatment of Choice" when it comes to chronic obstructive lung disease (particularly COPD) and is beneficial to many other chronic lung diseases as well. Pulmonary Rehabilitation is medically recognised as the best practice (for COPD patients) with benefits that outweigh treatment with medication alone. It involves a wide team of specialists such as physiotherapists, dietitians, social workers, community support workers, psychologists, as well as many others, including your GP. 

What does Pulmonary Rehabilitation include?

As a patient you might feel that walking 100 yards on a flat level with stops to catch your breath means that the idea of attending an exercise based programme is impossible. The benefits recorded in the scientific literature show the benefits listed below can be achieved even in the most severe COPD patients. The programme is individually adapted to your specific needs to help you achieve some of these benefits.

The programme will include the following to maximise the benefits to each patient:

1. a comprehensive and individual one to one assessment prior to beginning the programme
2. a supervised exercise class that runs twice a week, for 8 weeks and is individually prescribed and delivered in a friendly and fun atmosphere by a specially trained team to meet your particular needs You will begin at a safe starting point for you
3. long term self management advice and education specific to your needs (including exercises you can do with family at home during the time of your programme)
4. re-assessment following the programme to measure your personal benefits against the goals set for you.
5. long term follow up and ongoing maintenance support
6. ongoing support through patient run groups and other agencies.

What benefits can you expect from attending Pulmonary Rehabilitation?

It is important to realise that the benefits from Pulmonary Rehabilitation are well documented in the medical literature as being common and achievable and that literature is from reputable scientific sources:

1. reduces frequency and severity of breathlessness at rest and on exertion
2. improves quality of life that is measurable
3. reduces number of hospital admissions and days spent in hospital
4. improves effective use of medication and adherence to other medical treatments
5. improves mood and motivation
6. reduces dependency on others
7. improves your daily function by improving muscle strength and function, cardiovascular fitness and exercise endurance.
8. improves control over your symptoms
9. reduces the number of urgent and routine clinician visits

 Hospital and Community Partnership

The Greenlane physiotherapy outpatient department traditionally has delivered pulmonary rehabilitation and will continue to do so. In 2012 however, there will be two other sites provided by our community based partners; The Laura Fergusson Trust. These sites will move according to the numbers of referrals and the location of those referred. They will be based in centres such as community gyms, local community halls, local Marae, local schools, amongst many others and will integrate with other agencies in the local community while being delivered by a team of specially trained staff. 

All patients will be offered the choice of location once the referral has been triaged via the Greenlane Clinical Centre.

A standardised referral process will be used and may come from the following (though not exclusively):

• General Practice
• Hospital Clinicians
• Pacific Health (Parish Nurses)
• Community Teams
• Other physiotherapists

Referrals will be recieved by the cardiorespiratory physiotherapy team at the Greenlane Clinical Centre who will decide whether you would be more suited to coming to the Greenlane Clinical Centre or can be seen in the Community. 

If you are referred following an admission to the hospital you will be contacted within one week of discharge from hospital to recieve an appointment in no more than two weeks of discharge.

If you are referred by your GP or other, but not following a hospital admission, you will be contacted within two weeks of referral to arrange an appointment in no more than four weeks from referral date.

If you have any questions or queries about your referral please call (09) 630 9803 ext 27703 and ask to speak with the cardiorespiratory physiotherapy team. 

Pulmonary Rehabilitation is a free service to all New Zealand residents in the ADHB catchment zone.