title: Pulmonary rehabilitation: WHAT WE KNOW AND WHAT WE NEED TO KNOW.
abstract: The multidisciplinary treatment of pulmonary rehabilitation (PR), which includes exercise training, self-management education, and psychosocial and nutritional intervention, is now a standard of care for chronic obstructive pulmonary disease (COPD) and has been incorporated into major guidelines. We must now focus efforts on improving its impact and widening its applicability. What is the direction of PR; where does it fit in the comprehensive care of the COPD patient; and how can clinicians best apply this important intervention? This was the charge of the roundtable discussion, Pulmonary Rehabilitation: Moving Forward, involving 20 experts from North America and Europe, which was convened in Fort Lauderdale, Florida, in early 2008. It is not meant to be an exhaustive review; rather, this report summarizes the roundtable proceedings, while providing direction to best position PR into the continuum of COPD care. By consensus, it was agreed upon that although PR is effective for other chronic respiratory diseases, the discussion focus was COPD since most of the evidence base and patient referral are for this disease. These proceedings provide insight into 3 broad areas appropriate for investigation or implementation: positioning PR in an integrated care model for COPD patients; improving the effectiveness of this intervention; and expanding the recognition, application, and accessibility to PR. It is the hope that this document will provide a catalyst for clinicians, investigators, and healthcare policy makers to help realize these goals as well as serve to suggest important areas for future research and development in PR.
authors.affiliation: Providence VA Medical Center, Brown University School of Medicine, Providence, Rhode Island, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Nici
authors.forename: Jonathan
authors.initials: J
authors.lastname: Raskin
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Rochester
authors.forename: Jean C
authors.initials: JC
authors.lastname: Bourbeau
authors.forename: Brian W
authors.initials: BW
authors.lastname: Carlin
authors.forename: Richard
authors.initials: R
authors.lastname: Casaburi
authors.forename: Bartolome R
authors.initials: BR
authors.lastname: Celli
authors.forename: Claudia
authors.initials: C
authors.lastname: Cote
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Crouch
authors.forename: Luis F
authors.initials: LF
authors.lastname: Diez-Morales
authors.forename: Claudio F
authors.initials: CF
authors.lastname: Donner
authors.forename: Bonnie F
authors.initials: BF
authors.lastname: Fahy
authors.forename: Chris
authors.initials: C
authors.lastname: Garvey
authors.forename: Roger
authors.initials: R
authors.lastname: Goldstein
authors.forename: Alison
authors.initials: A
authors.lastname: Lane-Reticker
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Lareau
authors.forename: Barry
authors.initials: B
authors.lastname: Make
authors.forename: François
authors.initials: F
authors.lastname: Maltais
authors.forename: James
authors.initials: J
authors.lastname: McCormick
authors.forename: Michael D L
authors.initials: MD
authors.lastname: Morgan
authors.forename: Andrew
authors.initials: A
authors.lastname: Ries
authors.forename: Thierry
authors.initials: T
authors.lastname: Troosters
authors.forename: Richard
authors.initials: R
authors.lastname: ZuWallack
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000639:trends*; D005060:Europe; D006801:Humans; D010353:Patient Education as Topic / Q000639:trends; D015397:Program Evaluation / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D014481:United States