Showing papers by "Martin J. Connolly published in 2004"
TL;DR: Around 40% of surveyed hospitals run a pulmonary rehabilitation programme and most of the programmes are similar in their format, content and staffing, despite the high prevalence of chronic obstructive pulmonary disease (COPD)-related disability in old age.
Abstract: Background: Respiratory disease is a common cause of disability in middle and late life. Pulmonary rehabilitation programmes improve exercise capacity and quality of life in patients with chronic lung diseases. However, currently, in the UK the availability of pulmonary rehabilitation programmes and their characteristics are unknown.Methods: We surveyed pulmonary rehabilitation programmes in terms of number, size, duration, content of educational and exercise programme, and staffing. We mailed a 17-item questionnaire previously used in Canadian study to 190 physiotherapy departments within acute hospitals in UK.Results: One hundred and seventy-one (90%) responses were received. Sixty-eight centres (40%) run a pulmonary rehabilitation programme (99% outpatient). Mean age of subjects was]=70 in only seven centres (10%), though most cited no upper age limit. Ninety-nine per cent of centres incorporated exercise training. Programmes recruited a median group size of 10 patients (range 4 - 17) at a given time w...
180 citations
TL;DR: The aims of this review are to explore recent initiatives in the management of patients during acute exacerbations and in the stable condition in moderate to severe chronic obstructive pulmonary disease.
Abstract: Chronic obstructive pulmonary disease (COPD) is a major
cause of hospital admission, morbidity disability and high
healthcare usage in old age. Worldwide prevalence of
COPD is estimated at 9.3 per 1000 males and 7.3 per 1000
females in all age groups. COPD has been projected
to increase in prevalence to become the fifth leading cause
of disability and fourth leading cause of mortality by 2020.
A recent study of the economic burden of COPD in developed
countries estimated the annual societal cost (indirect
cost including loss of productivity) at $3511 per patient in
the UK. The report also confirmed COPD as being relatively
undiagnosed in the elderly, especially in the UK compared
with other countries.
Acute exacerbations (AECOPD) are a common cause
of hospital admission in patients with COPD. A patient
with moderate to severe COPD is most likely to have on
average three exacerbations per year with an average
length of hospital stay of 11 days, corresponding to a million
hospital bed days in UK hospitals. There were
approximately 10,000 AECOPD admissions per million
population of 75-84 year olds in England in 2000, 10 times
the corresponding figure for 45-64 year olds. A wide
range of other factors have been reported as predictors of
hospital admissions in COPD patients: these include low
forced expiratory volume, impaired quality of life, physical
disability and clinical anxiety as well as atmospheric pollution
and flu outbreaks. Length of hospital stay is
predicted by depression, number of co-morbidities and
advanced age.
The aims of this review are to explore recent initiatives
in the management of patients during acute exacerbations
and in the stable condition in moderate to severe chronic
obstructive pulmonary disease. The review is timely given
the current interest in COPD management as highlighted
by the very recent publication of the National Institute of
Clinical Excellence (NICE) guidelines for the management
of the condition.
1 citations