Effective pulmonary rehabilitation for persons with COPD in Germany

In Germany, 13.2% of the population older than 40 are affected by chronic obstructive pulmonary disease (COPD). By 2020, COPD will be the third most common cause of morbidity and mortality worldwide. In the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2018; 115: 117-23), the group of authors led by Rainer Gloeckl investigates the question to which extent pulmonary rehabilitation can contribute to improving the quality of life of persons with COPD.

The study shows that the level of evidence in favor of pulmonary rehabilitation (PR) in COPD is high: improvements in physical performance ability, dyspnea, and overall quality of life reach significance. PR is an individual, patient-centered therapy program that is based on a comprehensive diagnostic evaluation and consists of patient education/training, physical exercise, and behavioral training. In view of the complexity of differentiated PR, the authors emphasize the importance of continuous supervision by a physician. They criticize the fact that PR in Germany is offered almost exclusively in rehabilitation hospitals. Outpatient services should urgently be set up and extended, in order to enable targeted referral to tailored PR services.