Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway.
BMJ Open. 2022 Feb 17;12(2):e053503. doi: 10.1136/bmjopen-2021-053503.
To examine the organisational settings, content and availability of comprehensive multidisciplinary pulmonary rehabilitation (PR) programmes for people with chronic obstructive pulmonary disease (COPD) in primary healthcare in Norway.
This was a cross-sectional survey study examining the content, organisational settings and availability of comprehensive multidisciplinary PR for people with COPD.
When the survey was conducted, Norway had 436 municipalities/primary healthcare services who were invited to participate.
The main outcome was the question related to accessibility to a PR programme in primary healthcare. We also examined in what degree the single interventions which are a part of a PR programme were one of the municipalities services and if there were regional differences regarding PR.
Of the 436 municipalities, 158 answered the survey (36% response rate), and the survey covered for 45% of the total population in Norway. Five per cent of the responders reported having multidisciplinary PR for patients with COPD. The most frequently reported single interventions that can be a part of a multidisciplinary PR programme were reported as follows: group exercise training for all diagnoses (27%), reablement (25%) and home-care treatment by a physiotherapist and/or occupational therapist (24%). Southern-Eastern Norway had a significantly lower number of these interventions than Western Norway, Central Norway, and Northern Norway (p<0.001).
Only 5% of the Norwegian primary healthcare services (municipalities) had a multidisciplinary PR programme for patients with COPD. PR is the most important and cost-effective treatment within integrated care of patients with COPD. National strategies are therefore needed to increase the availability of PR for patients with COPD in Norwegian municipalities.
调查挪威初级卫生保健中针对慢性阻塞性肺疾病(COPD)患者的综合多学科肺康复(PR)计划的组织环境、内容和可及性。
这是一项横断面调查研究,调查了 COPD 患者综合多学科 PR 的内容、组织环境和可及性。
在进行调查时,挪威有 436 个市/初级卫生保健服务机构受邀参加。
主要结果是与初级卫生保健中 PR 计划的可及性相关的问题。我们还检查了作为 PR 计划一部分的单一干预措施在多大程度上是市服务的一部分,以及 PR 是否存在区域差异。
在 436 个市中,有 158 个市回答了调查(回应率为 36%),调查涵盖了挪威总人口的 45%。5%的回应者报告说为 COPD 患者提供多学科 PR。最常报告的可作为多学科 PR 计划一部分的单一干预措施如下:针对所有诊断的团体运动训练(27%)、再能力建设(25%)以及物理治疗师和/或职业治疗师的家庭护理治疗(24%)。与西部、中部和北部挪威相比,东南挪威的这些干预措施数量明显较少(p<0.001)。
挪威只有 5%的初级卫生保健服务机构(市)为 COPD 患者提供多学科 PR 计划。PR 是 COPD 患者综合护理中最重要和最具成本效益的治疗方法。因此,需要制定国家战略,增加挪威市 COPD 患者获得 PR 的机会。