The goal of rehabilitation is to restore a patient to the fullest medical, mental, emotional, social, and vocational potential possible. Pulmonary rehabilitation is increasingly recognised as an important component of the comprehensive management of patients with severe symptomatic lung disease. Pulmonary rehabilitation has gradually become the ‘gold standard’ for patients with severe lung disease, the most common of which is chronic obstructive pulmonary disease (COPD). Most frequently, pulmonary rehabilitation becomes necessary as respiratory function deteriorates as a result of disease. With therapeutic strategies such as lung volume reduction surgery and lung transplantation now available to patients formerly deemed untreatable, pulmonary rehabilitation is considered essential as an adjunct to surgery. This is done both to optimise the condition of patients prior to surgery as well as to ensure long term maintenance of their health status post surgery. The major objectives are to control, alleviate and, if possible, reverse the symptoms and pathophysiologic processes leading to respiratory impairment. An equally important aim is to improve the quality of the patient's life and to attempt to prolong it. This, in turn, leads to reduced healthcare costs and burden of care.
Latest statistics on COPD
COPD has been shown as a leading cause of death, illness and disability worldwide:
Case management is carried out according to the Life Rehabilitation standard process, which includes a personal pre-admission patient assessment to establish the potential benefits of rehabilitation and to optimise appropriate admissions with regards to timing and patient condition. The funder will receive a 10 day authorisation request for the programme. Admission and discharge reports will be sent to the funder and referring specialists. When ready to refer a patient, the referring specialist should contact the closest unit. The rehabilitation admissions consultant will personally visit the patient to assess him or her and discuss admission and any queries with the referring specialist, the patient and his or her family.
Criteria for admitting patients
The criteria for admitting patients for pulmonary rehabilitation include the following:
Pulmonary rehabilitation programme
The structured inpatient programme runs for a period of two weeks (with weekend leave in between). The holistic and interdisciplinary programme includes both individual and group sessions. Appropriate referrals are made after discharge and resources are provided. A follow-up assessment will be arranged to ensure maintenance of improved health status.
The programme is inclusive of the following services:
The team members are responsible for the following interventions:
The focus in intervention is based on the following:
Interventions will be individually targeted around the results of a variety of standardised and internationally recognised assessments, which cover functioning of respiration, mobility, mood, cognition and nutritional status. The programme includes interaction with other patients experiencing similar challenges to foster peer support, and ensures that the patient is discharged a more informed and better conditioned individual with greater coping skills.
Outcomes of pulmonary rehabilitation in patients with advanced COPD show the following:
The cost-effective, comprehensive tariff is inclusive of all professional services. Only medication and assistive devices (if necessary) are additional to the tariff.