Claire Nolan

The newest medical research is putting a spotlight on the care and delivery of pulmonary rehabilitation in patients with non-COPD chronic respiratory disease. Although the evidence to support pulmonary rehabilitation is well established in the management of COPD, there is growing clinical interest in and an emerging evidence base for this treatment strategy in patients with non-COPD chronic respiratory diseases.

The evidence to support this intervention in some of the most common non-COPD chronic respiratory diseases, as well as strategies to tailor the education component of pulmonary rehabilitation for these conditions, will take center stage during today’s session. Session Co-Chair Claire Nolan, BSc, MSc, PhD, senior research physiotherapist and pulmonary rehabilitation physiotherapy lead at the Royal Brompton and Harefield NHS Foundation Trust in London, and Roger Goldstein, MD, a respiratory medicine specialist at West Park Healthcare Center in Toronto, will lead a panel of experts to explore the role pulmonary rehabilitation plays in the management of interstitial lung disease, asthma, pulmonary arterial hypertension, and lung transplantation.

“Pulmonary rehabilitation, a comprehensive intervention, is designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors,” said Dr. Nolan. “It’s important that we appropriately manage patients with non-COPD respiratory diseases in pulmonary rehabilitation and understand the educational needs of these populations.”

When appropriately referring patients with these diseases to pulmonary rehabilitation, Dr. Nolan said the referring physician must be aware of what pulmonary rehabilitation involves, treatment inclusion and exclusion criteria, and optimal, ongoing medical management. 

Underscoring the importance of serving the educational needs of people with non-COPD chronic respiratory disease, Dr. Nolan said they are similar to those patients with COPD. This includes teaching them how to manage breathlessness, nutrition, anxiety, and exercise.  However, she said there are some differences that involve adapting care to the different non-COPD diseases, such as medication, oxygen use, and end-of-life care.

Moving forward, experts recommend increasing accessibility to pulmonary rehabilitation by considering the use of telehealth, implementing new technologies, securing funding to maintain existing pulmonary rehabilitation programs and create new ones, and providing solutions to the barriers of participation. Collaborative self-management strategies and methods for translating gains in exercise capacity into increased physical activity are equally important.

“The most important thing for physicians to remember is that pulmonary rehabilitation, an exercise and education program, is an integral component of the management of all patients with chronic respiratory diseases,” Dr. Nolan said.