Canadian consensus recommendations for a research agenda in pulmonary rehabilitation post-acute exacerbation of COPD: A meeting report

RATIONALE: A recent Cochrane review concluded that Pulmonary Rehabilitation (PR) post-acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is safe, reduces hospital admissions and improves quality of life and exercise capacity of patients post-AECOPD. Despite these benefits, recent reports have highlighted poor referral, uptake and completion rates of early post-AECOPD PR. These concerns provided the foundation for the “PR Post-AECOPD Meeting”, which was funded by the Canadian Institutes of Health Research and held in Montreal in November 2017.OBJECTIVES The objectives were to identify key research priorities in the complex area of care of delivering PR post-AECOPD.METHODS Meeting participants were asked to complete a pre-meeting survey in order to foster thinking prior to the beginning of the discussions. The first day of the meeting involved presentations from experts and a review of the pre-meeting survey results. Facilitated small group discussions occurred using the consensus building technique (Strengths, Weaknesses, Opportunities, and Threats [SWOT] method). The second day focused on large group discussions in order to identify the research themes.RESULTS The top three research themes identified were: 1) a phased approach to PR post-AECOPD, 2) patient-centered interventions and outcomes and 3) gaining a greater understanding of the emotional and psychological impacts of AECOPD. Other identified themes were: how to improve referral, uptake and access to PR post-AECOPD, how to reach under-served patient groups and cost-effectiveness of potential individualized interventions.CONCLUSIONS In this meeting, the stakeholders identified research priorities that should guide clinicians and researchers in their efforts to produce high-quality evidence.