Godtfredsen Nina Skavlan, Grann Ove, Larsen Hanne Bormann, Sørensen Tina Brandt, Lavesen Marie, Pors Birthe, Dalsgaard Lone Sander, Kristiansen Luise Cederkvist, Andersen Klaus Kaae, Dollerup Jens
Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
Clin Respir J. 2012 Jul;6(3):186-92. doi: 10.1111/j.1752-699X.2011.00272.x. Epub 2011 Nov 29.
Implementation of pulmonary rehabilitation in primary health care in Denmark is a new challenge in the management of patients with chronic obstructive pulmonary disease (COPD).
To assess the feasibility of introducing a nationwide web-based tool for data recording and quality assurance in the rehabilitation programmes and to evaluate whether patients are referred correctly according to Danish guidelines for community based COPD rehabilitation.
Participation in the KOALA project has been offered to the municipalities since October 2007. As of October 2010, 62 health-care centres have been invited to participate. We present summary statistics and correlation analyses of the 1699 patients who have been enrolled so far.
Thirty-three municipalities are currently engaged in the KOALA project. Descriptive analyses reveal that 33% of the patients do not meet the criteria for pulmonary rehabilitation in terms of dyspnoea upon exertion at the baseline visit. Furthermore, information on severity of COPD is missing for 18% of the attendants. The majority of the referred patients have moderate COPD, which is in accordance with the intentions of rehabilitation in the community. Statistical analyses show that COPD-level and grade of dyspnoea are positively correlated and expose significant correlations between both COPD-level and dyspnoea and 6 minutes walking distance (6MWD), incremental shuttle walk distance (ISWT) and quality of life.
We conclude that the municipalities in general are interested in the KOALA project as a mean of data recording and sharing and as a quality instrument. Summary statistics show that there is room for improvement in referral and baseline assessments of patients suitable for pulmonary rehabilitation in a community setting.
在丹麦初级卫生保健中实施肺康复是慢性阻塞性肺疾病（COPD）患者管理中的一项新挑战。
评估引入一种全国性的基于网络的工具用于康复项目数据记录和质量保证的可行性，并评估患者是否根据丹麦社区COPD康复指南得到正确转诊。
自2007年10月起向各市提供参与考拉项目的机会。截至2010年10月，已邀请62个医疗保健中心参与。我们展示了目前已登记的1699名患者的汇总统计数据和相关性分析。
目前有33个市参与了考拉项目。描述性分析显示，33%的患者在基线访视时根据运动时呼吸困难情况不符合肺康复标准。此外，18%的参与者缺少COPD严重程度信息。大多数转诊患者患有中度COPD，这与社区康复的意图相符。统计分析表明，COPD级别和呼吸困难分级呈正相关，且COPD级别、呼吸困难与6分钟步行距离（6MWD）、递增穿梭步行距离（ISWT）和生活质量之间均存在显著相关性。
我们得出结论，各市总体上对考拉项目感兴趣，将其作为数据记录和共享的手段以及一种质量工具。汇总统计数据表明，在社区环境中，适合肺康复患者的转诊和基线评估方面仍有改进空间。
