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.