The Need for Expanding Pulmonary Rehabilitation Services

Area of Science:

• Pulmonology
• Rehabilitation Medicine
• Public Health

Background:

• Pulmonary rehabilitation is a vital treatment for chronic lung disease.
• Global access to pulmonary rehabilitation remains critically low, affecting less than 3% of eligible patients.
• Numerous barriers, including organizational, practitioner, and patient-related factors, impede referral, uptake, and completion.

Purpose of the Study:

• To highlight the significant issue of poor accessibility to pulmonary rehabilitation worldwide.
• To discuss the challenges in delivering pulmonary rehabilitation, particularly in rural, remote, and low-income settings.
• To emphasize the need for innovative solutions, accelerated by the COVID-19 pandemic, for remote and efficient program delivery.

Main Methods:

• Literature review and synthesis of existing evidence on pulmonary rehabilitation accessibility.
• Analysis of documented barriers to referral, uptake, and completion.
• Discussion of current and potential models for pulmonary rehabilitation delivery.

Main Results:

• Knowledge enhancement initiatives show limited sustainable impact on access.
• Alternative service delivery models are underutilized in clinical practice.
• The COVID-19 pandemic underscored the necessity for remote pulmonary rehabilitation solutions.

Conclusions:

• Urgent strategies are required to overcome the low accessibility of pulmonary rehabilitation.
• Addressing challenges in diverse settings, including rural and low-income regions, is paramount.
• Integrating remote and alternative models is crucial for expanding access and improving care for individuals with chronic lung disease.