Chronic obstructive pulmonary disease (COPD) rehabilitation at primary health-care centres - the KOALA project

Implementation of pulmonary rehabilitation in primary health care in Denmark is a new challenge in the management of patients with chronic obstructive pulmonary disease (COPD).

To assess the feasibility of introducing a nationwide web-based tool for data recording and quality assurance in the rehabilitation programmes and to evaluate whether patients are referred correctly according to Danish guidelines for community based COPD rehabilitation.

Participation in the KOALA project has been offered to the municipalities since October 2007. As of October 2010, 62 health-care centres have been invited to participate. We present summary statistics and correlation analyses of the 1699 patients who have been enrolled so far.

Thirty-three municipalities are currently engaged in the KOALA project. Descriptive analyses reveal that 33% of the patients do not meet the criteria for pulmonary rehabilitation in terms of dyspnoea upon exertion at the baseline visit. Furthermore, information on severity of COPD is missing for 18% of the attendants. The majority of the referred patients have moderate COPD, which is in accordance with the intentions of rehabilitation in the community. Statistical analyses show that COPD-level and grade of dyspnoea are positively correlated and expose significant correlations between both COPD-level and dyspnoea and 6 minutes walking distance (6MWD), incremental shuttle walk distance (ISWT) and quality of life.

We conclude that the municipalities in general are interested in the KOALA project as a mean of data recording and sharing and as a quality instrument. Summary statistics show that there is room for improvement in referral and baseline assessments of patients suitable for pulmonary rehabilitation in a community setting.