Profiling of Patients with COPD for Adequate Referral to Exercise-Based Care: The Dutch Model

Martijn A. Spruit*, Alex Van't Hul, Hilde L. Vreeken, Emmylou Beekman, Maria H. T. Post, Guus A. Meerhoff, Anne-Loes Van der Valk, Cor Zagers, Maurice J. H. Sillen, Martijn Vooijs, Jan Custers, Jean Muris, Daniel Langer, Jos Donkers, Marleen Bregman, Leendert Tissink, Erik Bergkamp, Johan Wempe, Sarah Houben-Wilke, Ingrid M. L. AugustinEline Bij de Vaate, Frits F. M. Franssen, Dirk Van Ranst, Hester Van der Vaart, Jeanine Antons, Mitchell Van Doormaal, Eleonore H. Koolen, Philip Van der Wees, Renee Van Snippenburg, Daisy J. A. Janssen, Sami Simons

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A loss of physical functioning (i.e., a low physical capacity and/or a low physical activity) is a common feature in patients with chronic obstructive pulmonary disease (COPD). To date, the primary care physiotherapy and specialized pulmonary rehabilitation are clearly underused, and limited to patients with a moderate to very severe degree of airflow limitation (GOLD stage 2 or higher). However, improved referral rates are a necessity to lower the burden for patients with COPD and for society. Therefore, a multidisciplinary group of healthcare professionals and scientists proposes a new model for referral of patients with COPD to the right type of exercise-based care, irrespective of the degree of airflow limitation. Indeed, disease instability (recent hospitalization, yes/no), the burden of disease (no/low, mild/moderate or high), physical capacity (low or preserved) and physical activity (low or preserved) need to be used to allocate patients to one of the six distinct patient profiles. Patients with profile 1 or 2 will not be referred for physiotherapy; patients with profiles 3-5 will be referred for primary care physiotherapy; and patients with profile 6 will be referred for screening for specialized pulmonary rehabilitation. The proposed Dutch model has the intention to get the right patient with COPD allocated to the right type of exercise-based care and at the right moment.

Original languageEnglish
Pages (from-to)1421-1429
Number of pages9
JournalSports Medicine
Volume50
Issue number8
DOIs
Publication statusPublished - Aug 2020

Keywords

  • FIELD WALKING TESTS
  • PULMONARY REHABILITATION
  • PHYSICAL-ACTIVITY
  • HEALTH-STATUS
  • EXACERBATION
  • DEPENDENCY
  • MEDICINE
  • CLUSTERS
  • DISTANCE
  • BATTERY

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