Rupert Jones1, Julie Backley2, Julia Bott3, Carol Langley4, Sally Singh5, Jenny Till6, Jo Bloom7, Judith Smith8
Addresses:
1. Respiratory Research Unit, Peninsula Medical School, N21 ITTC Building, 1 Davy Road,
Plymouth, PL6 8BX
2. Pulmonary Rehab Team, West Home, Dulwich Hospital, East Duwlich Grove, London SE22
8PT
3. North Surrey PCT, Ashford Hospital, London Road, Ashford, Middlesex, TW15 3AA
4. PACE Team, 51 Rowden Hill, Chippenham Community Hospital, Chippenham, SN15 2AJ
5. Department of Pulmonary Rehabilitation, Glenfield Hospital, University Hospitals of Leicester,
Groby Road, Leicester, LE3 9QP
6. Morecombe Bay PCT, Burton Road, Kendle, LA9 7GL
7. British Lung Foundation, 73-75 Goswell Road, London EC1V 7ER
8. Boston Borough Council Offices, Room 512, West Street, Boston, Lincs, PE21 8QR
Background
Despite excellent evidence for PR, it is currently available to 2% of those who need it. To meet the demand, PR in the community is growing. Existing guidelines do not address all the issues facing community PR. A meeting to share best practice was held at the GPIAG national conference, in July 2005, for those involved in setting up and delivering community PR.
Methods
Sixty two people attended including multidisciplinary clinicians and patient advocates. In groups they discussed:
1. Assessing patients
2. The exercise component
3. The education component
4. Safety & venues
5. Follow up & maintenance
They considered which components were (1) essential, (2) desirable, (3) insufficient evidence to draw conclusions. Their recommendations were discussed in a plenary, and final conclusions drawn.
Results
A comprehensive series of recommendations was produced. This included how patients should be assessed, suitable outcome measures, exercise modalities, education topics and staff. Safety issues including training, competence and equipment, e.g. for resuscitation and oxygen, and suitable follow up arrangements were recommended.
Discussion
This group considered the practicalities of establishing and running pulmonary rehabilitation in the community. Their recommendations, conclusions, should be considered as guidance to help promote effective, safe practice and support clinicians.
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