Is the training intensity during the home‐based programme intense enough to improve exercise capacity in COPD patients with a mildly impaired exercise tolerance at the start of the intervention45? A Qualitative Interview Study. Process . To conclude, patients and healthcare professionals have to combine the most appropriate pulmonary and extra‐pulmonary targeted therapies, for patients with a chronic respiratory disease who are still symptomatic despite otherwise optimal medical therapy, aiming at relevant outcomes. So, walking programmes in the home‐based setting seem feasible, safe and effective to increase exercise performance to some extent. Further studies are needed in order to define the long-term benefits as well as the optimal programme structure to get the greatest effects. The audit collected information on the resourcing and organisation of PR services relevant to the care of adult …  |  Pulmonary rehabilitation programs need to move away from a supply-driven functional organizational structure towards integrated structures, including the full range of medical expertise, technical skills and specialized facilities needed to compete on added value in the management of patients with chronic respiratory diseases. You may have pulmonary rehabilitation in the hospital or a clinic, or you may learn physical therapy or breathing exercises to do at home. Structure of pulmonary rehabilitation Frequency of supervised pulmonary rehabilitation sessions Pulmonary rehabilitation programmes should be a minimum of twice-weekly supervised sessions. Structure. Setting and participants. Pulmonary rehabilitation (PR) is recognized as the prevailing standard of care for patients with chronic respiratory conditions. However, multiple surveys show a huge variation in the number of healthcare disciplines available within and between countries.3, 34-36 Moreover, the content of pulmonary rehabilitation programmes as well as its frequency and duration vary to a great extent.3, 34-36 These disparities may, at least partially, be caused by differences in the local reimbursement of pulmonary rehabilitation services,37 ranging from paying out of pocket by the patient up to full reimbursement by insurance, employer and/or government.3 This will complicate bench marking of key indicators of structure, process and performance, and, in turn, confuse quality control of existing and new pulmonary rehabilitation services.38, Home‐based ‘pulmonary rehabilitation’ is emerging as a new format of pulmonary rehabilitation,39 which mostly consist of a home‐based exercise training programme (i.e. Once we receive the referral and all the required information from your physician, our dedicated staff will contact you to set up an interview and orientation to the program. While the influence of pulmonary rehabilitation on dyspnoea, … At first, a Swiss army knife looks just a simple pocket knife. It is generally recognized that pulmonary rehabilitation is a comprehensive multidisciplinary intervention. Improving Exercise-Based Interventions for People Living with Both COPD and Frailty: A Realist Review, Exploration of n-6 and n-3 Polyunsaturated Fatty Acids Metabolites Associated with Nutritional Levels in Patients with Severe Stable Chronic Obstructive Pulmonary Disease, Special Issue: REHABILITATION IN CHRONIC RESPIRATORY DISEASES. However, timely referral by the general practitioner (GP) to the next level of care (horizontally or vertically) is imperative. Internationally, there is also no expert consensus, mainly due to large differences in local situations.3 Historically, the degree of airflow limitation has been used to select patients with COPD for pulmonary rehabilitation.4, 5 However, just using the degree of lung function impairment is not enough to truly understand the physical, emotional and social conditions of adults with a chronic respiratory disease.6-13 Indeed, dyspnoea, fatigue, dynamic hyperinflation, a reduced physical capacity, an impaired disease‐specific health status and social deprivation already occur in patients with a mild degree of airflow limitation.14-17 Moreover, the degree of lung function impairment at entry to the pulmonary rehabilitation cannot forecast the efficacy of the programme.18-21, The degree of disease complexity, derived from a comprehensive initial assessment, should determine the type of intervention as well as the rehabilitation setting. Journal of the American Medical Directors Association.