Scientific evidence to support the content and structure of the education component of a pulmonary rehabilitation program is limited. Survey data and expert opinion have been used to identify recommended educational topics.
Based on results from a survey* of patients who had completed a pulmonary rehabilitation program in Australia, the most important educational topics (in order) were:
- The role and correct use of medications.
- Breathing techniques / managing breathlessness.
- Physical exercise.
- Nutrition / healthy eating.
- Information on diseases (e.g. what the lungs do).
- Coping with chronic lung disease and management of depression, anxiety and panic attacks.
These topics should form the basis of the education component of a pulmonary rehabilitation program. These topics should be covered early in the program.
* The survey was conducted by The Australian Lung Foundation in 2000. The survey data were obtained from more than 200 patients with chronic obstructive pulmonary disease in Australia, who had attended pulmonary rehabilitation programs.
In the United Kingdom, the ‘Living Well with COPD for Pulmonary Rehabilitation Programme’ was developed and evaluated in 11 pulmonary rehabilitation programs to enable delivery of consistent education to patients during pulmonary rehabilitation (Cosgrove D et al Facilitation of education in pulmonary rehabilitation using the living well with COPD programme for pulmonary rehabilitation.4 The program provides content and materials for similar education sessions to those listed above, and is supported by an online website and resources for health professionals and patients. http://www.livingwellwithcopd.com/living-well-and-pulmonary-rehabilitation.html
Other education topics may include:
- Sputum clearance.
- Energy conservation techniques.
- Sexuality issues.
- Community resources, legal issues and palliative care.
- Home Oxygen
Delivery of education within a pulmonary rehabilitation program should be individualised for each patient. Not all education topics may be relevant or desirable for all patients and participation in group sessions may be voluntary. The format of the content and the level of detail in the education sessions should be determined based on the:
- Needs of the participants.
- Availability of resources.
- Level of staff expertise.
Pulmonary rehabilitation is recommended for:
People with stable COPD of all severities i.e mild, moderate or severe.
- People with COPD after a hospitalisation for an exacerbation (ideally PR should be accessed within two weeks of hospital discharge).5
- People with bronchiectasis, interstitial lung disease or pulmonary hypertension
Taking the above points into consideration, the online patient education tool C.O.P.E (COPD online patient education) could be considered as an appropriate option for patients to undertake specific educational components to complement their pulmonary rehabilitation program.