Exploring a physiotherapy well-being review to deliver community-based rehabilitation in patients with pulmonary hypertension

KEEN, Carol, HASHMI-GREENWOOD, Molly, YORKE, Janelle, ARMSTRONG, Iain, SAGE, Karen and KIELY, David (2019). Exploring a physiotherapy well-being review to deliver community-based rehabilitation in patients with pulmonary hypertension. Pulmonary Circulation, 9 (4). [Article]

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Abstract
Background: Highly structured, supervised exercise training has been shown to be beneficial in patients with pulmonary hypertension. Despite evidence of the effectiveness of community-based rehabilitation in other cardiopulmonary diseases there are limited data in patients with pulmonary hypertension. Methods: This prospective study evaluated the intervention of a physiotherapist well-being review in patients with pulmonary hypertension who had been established on targeted drug therapy for between 3 and 12 months. The intervention included a detailed consultation assessing functional, social and motivational status to identify individual patient rehabilitation goals and facilitate tailored referrals to community-based services. Results: One hundred and thirty eight patients (79% pulmonary arterial hypertension, 17% chronic thromboembolic disease), age 67±14 years, diagnosed over a one year period were evaluated between July 2017 and January 2018. Fifty-two percent of patients were referred to community-based pulmonary rehabilitation programmes, 19% received other forms of community rehabilitation, 17% were given exercise advice, 5% had an assessment of social support and 7% declined any intervention. At the end of the study 32% of patients were undertaking independent exercise. Conclusion: This study has identified that the majority of patients with pulmonary hypertension who are optimised on targeted drug therapy have rehabilitation needs. The use of a physiotherapy well-being review can identify this need and facilitate access to community-based rehabilitation. Further research is required to evaluate the efficacy of such interventions in pulmonary hypertension.
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