Abstract
Introduction:Pulmonary rehabilitation (PR) improves clinical outcomes in patients with chronic respiratory conditions though access to and completion of PR remains challenging. We investigated the outcomes of regular consultant-led multidisciplinary meetings (MDMs) on PR at a tertiary hospital.
Methods:A qualitative retrospective study of all consultant-led PR MDMs over a 12-month period. All clinical notes, action points and clinical letters generated from these MDMs were reviewed, coded and analysed using content analysis.
Results:49 (7.6%) out of 643 PR referrals were discussed at the MDMs and were reviewed; 32 (65%) had COPD with mean (SD) FEV1 48.5 (16.5) % pred. The referrals were from general practice 20 (41%), respiratory clinics 10 (20%), integrated respiratory care 10 (20%) and in-patient respiratory team 9 (19%). Three themes were identified 1) diagnosis uncertainty; 2) comorbidities that required further investigation to ascertain safety to exercise; 3) respiratory medication optimisation. 11 (23%) cases discussed were due to diagnosis uncertainty; most commonly due to lack of valid spirometry. 30 (61%) were due to complex comorbidity with potential contraindications to exercise, 9 (18%) cases required medication optimisation. 25 (51%) patients started PR; of those 20 (40%) had completed and 5 (10%) were actively engaged in PR. 5 (10%) were deemed inappropriate referrals, 19 (39%) did not start PR.
Conclusion:成功设计mdm optimised the delivery of PR in clinically complicated patients. Further study should investigate the impact of consultant-led MDMs on the engagement and completion of PR in a case-control design.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3977.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available atwww.ers-education.org(ERS member access only).
- Copyright ©the authors 2019