Availability and characteristics of pulmonary rehabilitation programs in family health centers and hospitals from Chile: cross-sectional and multicentric study

Abstract

Pulmonary rehabilitation (PR) improves clinical outcomes, although is not widely offered and programs are heterogeneous. In Chile, only one study has characterized the programs, however the evidence is scarce. We aimed to determine availability and characteristics of PR programs performed in family health centers and hospitals from Chile. A quantitative, observational, descriptive and cross-sectional study was designed over programs from centers and hospitals performed in 2019. A non-probability and convenience sample was obtained. Availability and characteristics of centers and programs were measured using a questionnaire translated from the literature, adapted, validated, and emailed. Of 80 obtained responses (22.8%), 60% of centers offered program, where lack of time was the greatest barrier (43.8%). Programs were outpatient (77.1%), non-personalized (31.3%), with 9-10 participants, 12-15.3 weeks of duration, 2-2.5 session/week, and 1-1.3 hours/session. Chronic Obstructive Pulmonary Disease (COPD) was the main diagnostic (59-95%). Components were strength exercises of lower extremity (70.3%), upper extremity (67.6%), walking (62.2%) and education (59.5%). Team was integrated by physiotherapist (67.6%) physician (37.8%), with completed training (43.8%), and directed by physiotherapist (56.3%). Modified Borg (59.5%), MRC dyspnea scale (59.5%), walking test (54.1%) and oximetry (43.2%) were used. 40-80% completed PR, and the major barrier was patient transfer (41.7%). Increasing the availability of PR and homogenization of programs is needed, with evaluation supported by scientific evidence, considering new models of PR.