6 October 2009
A nurse-led programme of exercise and education has helped to improve walking distances and quality of life for COPD patients on the Isle of Wight.
The Isle of Wight PCT scheme promotes self-care and management through individually tailored programmes of exercise and education.
The first cohort of patients almost doubled the distance they were able to cover during an incremental shuttle walk test before and after the programme.
Patients also achieved clinically important improvements in performance on the breathing problems questionnaire.
The PCT previously ran a programme for patients referred from respiratory consultants, but a lack of funding meant that few patients could be taken onto this scheme.
Respiratory nurse specialist Sarah Kearney has led the project to expand the programme, working alongside physiotherapists and a trainee clinical psychologist.
'With overwhelming evidence in support of pulmonary rehabilitation, we wanted to be able to offer the programme to all island residents, not just those who were referred through the chest clinic,' Ms Kearney said. 'Funding was secured as part of a wider COPD initiative through practice-based commissioning and partnership working with commissioners.'
The scheme now allows referral from GPs and has been expanded to include psychological therapies aimed at improving patients' confidence in managing their own condition.
'In COPD, one of the best and well-evidenced predictors of how well an individual will manage appears to be how confident they are about managing breathing difficulties,' Ms Kearney said 'Our programme has dedicated psychological input, meaning we can specifically address service users' perception of breathing difficulty and provide an individualised programme of support,' she added.
Ms Kearney believes the new programme will reduce emergency hospital admissions for COPD.
'We are confident this project will lead to greater cost-effectiveness and optimise individuals' chances of sustaining the benefits of pulmonary rehabilitation,' she said.
The PCT spends £2,000 each time a COPD patient is admitted to hospital. In 2006/7 there were 305 emergency admissions and this was expected to increase as prevalence of the disease rose.
The team is now hoping to develop a cohort of expert 'graduates' of the program who can offer advice to others and encourage continued exercise.
It will also look at improving systems to help patients avoid being admitted to hospital and to allow early discharge.
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