Pulmonary Rehabilitation

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Pulmonary Rehabilitation

• Evaluating a TelePulmonary Rehabilitation Program
  
• From Urban to Rural Alberta

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Communities Join Forces
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Definition of COPD

• COPD is a respiratory disorder largely caused by
  smoking, which is characterized by progressive,
  partially reversible airway obstruction, systemic
  manifestations, and increasing frequency and
  severity of exacerbations.
• COPD is a preventable and treatable disease.
• . Eur Respir J 200423932-46

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COPD Statistics

• 750,000 Canadians suffer from COPD.
• In 2000 COPD was the fourth leading cause of
  Chronic morbidity and mortality in Canada.
• Since 1980 the mortality rate of COPD in Canadian
  women has increased by more than 200.

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COPD Statistics

• COPD has replaced breast cancer as the leading
  cause of death among women in Canada.
• COPD will be responsible for 1 out of 5 deaths
  among men within seven years.

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COPD Statistics

• COPD is costing the Canadian health care system
  an estimated 3.2 billion dollars a year.
• COPD is responsible for 13 of all
  hospitalizations.
• The average length of stay is 14.5 days.

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COPD Statistics

• 40 - 50 of COPD patients discharged from
  hospitals are readmitted within the year.
• While the mortality rates for heart disease,
  cancer and stroke have declined during the past
  decade, the death rate for COPD is increasing.
• A Canadian dies every hour from COPD.

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The Lung Association Canadian Thoracic Society
COPD Guidelines
Ideal management of COPD
Current management of COPD in Canada
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Pulmonary Rehab

• Rehabilitation
• Promote patient self management
• Reduced dyspnea
• Increased exercise tolerance
• Reduced healthcare resources
• Improved quality of life

• Management
• Prevent disease progression
• Reduce dyspnea
• Improve exercise tolerance
• Prevent and treat exacerbations
• Improve health status and quality of life
• Reduce mortality

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The Caritas Centre for Lung Health at The
Edmonton General Continuing Care Centrehas been
providing Pulmonary Rehab. for 15 years
Pulmonary Rehabilitation Program Components

• Education Exercise Support
• Breathing retraining Breathing
  exercises Smoking cessation
• Warning signs Stretching Weight loss
  / gain
• Inhaler technique Strengthening Peer
  Support
• Nutrition Endurance (COLD Club)
• Relaxation
• Lifestyle changes

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Telehealth Regions

• R5 - East Central
• Camrose
• Vermillion
• Wainwright
• Killam
• R4 - David Thompson
• Drayton Valley
• R9 - Northern Lights
• in the near future

• R8 - Peace Country
• Grande Prairie
• Peace River
• R7 - Aspen
• Athabasca
• Elk Point
• St. Paul
• Bonnyville
• Cold Lake
• Barrhead

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Pulmonologist Consultations

• Pre and Post Program Pulmonologist consults are
  performed.
• The following test results are reviewed at the
  initial consult
• 12 minute walk with oximetry
• Pulmonary Function Test
• Baseline Electrocardiogram
• Chest X-Ray
• Patients participate in the education and
  exercise program every
• Tuesday and Thursday for 8 weeks

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St. Georges Respiratory Quality of Life
Questionnaire Outcomes
Telehealth Outcomes

• Symptoms 47.4 (1.32)
• Activities 146.3 (4.06)
• Impacts 643.7 (17.88)
• Total 390.6 (10.85)

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January 2006 April 2007

• Edmonton
• Enrolled 156
• Complete 138 (88)
• Incomplete 18 (12)
• Male 77 (49)
• Female 79 (51)
• Average age 68 yrs

Rural Alberta Enrolled 82 Complete 68
(83) Incomplete 14 (17) Male 48
(58) Female 34 (42) Average age 68
yrs
Initial Clinical Assessments 112
Total Patient Education Sessions 654
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12 minute walk results

• Change in distance
• Increase
• Average distance change
• No change
• Decrease
• Change in dyspnea
• Increase
• No change
• Decrease

Edmonton 108 (79) 27 13 (9) 16
(12) 25 (18) 50 (67) 62 (45)
Rural Alberta 54 (82) 70 2 (3) 10
(15) 28 (44) 11 (17) 25 (39)
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Summary Report

• A final summary report is sent out to the
  referring physician as well as the family
  physician. If a patient is on supplementary
  oxygen the Respiratory Home care company will
  also receive a copy of the report to help in the
  follow up process.
• Attendance
• Resting and Exertional Sp02 and Heart Rate
• Pre and Post program results for endurance
  activities
• Pre and Post assessment data
• Patient Evaluation

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Testimonials

• By attending this course I have finally
  understood COPD, what it does to your lungs, and
  how it affects your breathing how oxygen,
  puffers and exercise can help me
• I would strongly recommend this program become
  mandatory for anyone who is diagnosed with COPD
  or any other breathing problems. It should be
  available in all our local hospitals

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Final Test
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Caritas Centre for Lung Health

• Edmonton General Continuing Care Centre
• 11111 Jasper Avenue
• Phone [phone]
• Fax [phone]
• Program Coordinator Tina Jourdain, RRT
• tinajourdain_at_caritas.cha.ab.ca