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BTS Clinical Statement
British Thoracic Society Clinical Statement on pulmonary rehabilitation
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  1. William Man1,
  2. Emma Chaplin2,
  3. Enya Daynes2,3,
  4. Alistair Drummond1,
  5. Rachael A Evans2,3,
  6. Neil J Greening2,3,
  7. Claire Nolan1,4,
  8. Matthew J Pavitt5,6,
  9. Nicola J Roberts7,
  10. Ioannis Vogiatzis8,
  11. Sally J Singh2,3
  1. 1 Royal Brompton & Harefield Hospitals, Guy’s and St.Thomas’ NHS Foundation Trust, London, UK
  2. 2 Centre for Exercise and Rehabilitation Science, NIHR Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
  3. 3 Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, Leicester, UK
  4. 4 Department of Health Sciences, College of Health Medicine and Life Sciences, Brunel University London, London, UK
  5. 5 University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  6. 6 Brighton and Sussex Medical School, Brighton, UK
  7. 7 School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
  8. 8 Department of Sport, Exercise and Rehabilitation, School of Health and Life Sciences, Northumberland University Newcastle, Newcastle Upon Tyne, UK
  1. Correspondence to Dr William Man; W.Man{at}rbht.nhs.uk

https://doi.org/10.1136/thorax-2023-220439

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    Introduction

    The evidence-based British Thoracic Society (BTS) Guideline for pulmonary rehabilitation (PR) in adults was published in 2013.1 There is a strong evidence base for the benefits of PR,2 and it is one of the most cost-effective interventions for adults with chronic obstructive pulmonary disease (COPD).3 Furthermore, PR improves exercise capacity and health-related quality of life (HRQOL) in COPD to a much greater magnitude than observed with bronchodilator therapy.4

    Since the Guideline, there is deeper understanding of referral characteristics, outcome measures, patient selection, programme delivery, potential adjuncts and the role of maintenance following PR. The BTS Clinical Statement on PR is a narrative review which provides a snapshot of current knowledge and best practice in topical areas by providing a series of clinical practice points that are informed by evidence where this exists, or based on expert opinion and collective clinical experience where evidence is limited.

    The Clinical Statement is not intended to be a comprehensive review as much of the BTS Guideline remains relevant today and does not need revisiting.1 Furthermore, BTS, alongside other respiratory societies, reviewed the current state of education in PR.5 The intended audience are PR clinicians working within health settings in the UK and beyond. The Clinical Statement will provide a framework to inform future BTS Quality Standards for PR. We have also highlighted areas of research priority, which will be of interest to clinical researchers.

    In this Statement, we highlight the growing interest in alternative models of delivering PR (eg, home based, remote supervision, use of technology), accelerated by the restrictions placed on face-to-face PR delivery during the global COVID-19 pandemic. These PR models, typically delivered remotely, might potentially increase provision of, and accessibility to PR. However, research gaps remain and it is crucial these models are optimised and …

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