Recent Article by S.C. Milner in New Collection from the Chronic Respiratory Disease Journal

A recent scientific journal article I published (2019) has just been included in a new collection from the Chronic Respiratory Disease Journal: Novel insights into acute exacerbations of chronic respiratory diseases.

The article concerned the acceptability, feasibility, and safety of a pulmonary rehabiliation (PR) “taster” session delivered before hospital discharge to patients with an acute exacerbation (sudden worsening) of chronic obsructive pulmonary disease (COPD).

PR is a program involving exercise training as a central modality to improve symptoms and slow the worsening of lung diseases such as COPD. PR helps patients with COPD and other chronic lung diseases gain strength, reduce symptoms of anxiety or depression, and makes it easier for such patient to carry out routine daily activities.

Acute exacerbations of COPD are associated with high rates of rehospitalization,1 worsened symptom severity,2 decreased exercise tolerance and physical activity,37 and negative impact on skeletal muscle,8,9 quality of life,7 mental health,3,10 and ability to self-care.11,12 

As such, there is a strong argument for the need for PR during and/or aftern an exacerbation,13 with a recent Cochrane review concluding that PR is safe, reduces hospital admissions, and improves quality of life and exercise capacity of patients post-AECOPD.14 

However, in spite of the strong evidence for PR, referral and completion rates of PR are low. One audit in a UK hospital found that of 286 patients with an AECOPD eligible for PR, only 31% were referred, and less than 15% went on to complete the program,13 with another study finding only 9% of post-AECOPD patients completed PR.15

An editorial introducing the articles in this special collection can be found here: Acute exacerbations of chronic respiratory disease: Progress and opportunities.

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