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BTS Guideline on Pulmonary Rehabilitation in Adults September 2013 Volume 68 Supplement 2 ThoraxAN INTERNATIONAL JOURNAL OF RESPIRATORY MEDICINE BTS Guideline on Pulmonary Rehabilitation in Adults British Thoracic Society Pulmonary Rehabilitation Guideline Group thorax.bmj.com tthoraxjnl_68_S2_Cover.inddhoraxjnl_68_S2_Cover.indd 1 119/07/139/07/13 55:58:58 PPMM Thorax Aims and Scope: Thorax enjoys an enviable AN INTERNATIONAL JOURNAL OF RESPIRATORY MEDICINE and longstanding reputation for publishing Journal of the clinical and experimental research articles British Thoracic Society Editorial Board E Abraham (USA) covering many disciplines, including A Agusti (Spain) H Aranibar (Chile) pathology, immunology and surgery E Baraldi (Italy) E Bateman (South Africa) J Bradley (UK) J Britton (UK) Contact Details (Netherlands) J de Jongste Editors N Maskell (UK) Editorial Offi ce O Eickelberg (Germany) A Bush (UK) S Nathan (USA) BMJ Publishing Group Ltd, BMA House, Tavistock J Fahy (USA) Square London, WC1H 9JR, UK I Pavord (UK) JL Pepin (France) M Fitzgerald (Canada) T Sethi (UK) T: +44 (0)20 7383 6373 Deputy Editors U Frey (Switzerland) M Steiner (UK) E: [email protected] P Cullinan (UK) J Gauldie (Canada) D Thickett (UK) M Han (USA) C Lloyd (UK) A Torres (Spain) J Henderson (UK) Associate Editors Z Udwadia (India) Permissions F Holguin (USA) R Beasley (New Zealand) H Zar (South Africa) See http://journals.bmj.com/misc/permissions.dtl R Hubbard (UK) R Buhl (Germany) Statistical Editors I Janahi (Qatar) JC Celedón (USA) J Gibson (UK) Supplement Enquiries R Kalhan (USA) (UK) A Custovic T McKeever (UK) T: +44 (0)20 7383 6057 A Knox (UK) P Gibson (Australia) Statistician E: [email protected] C Kuehni (Switzerland) J Grigg (UK) L Szatkowshi (UK) G Lack (UK) D Halpin (UK) F Maltais (Canada) A Jones (UK) Journal club Editor For ALL subscription enquiries and orders D Mannino (USA) E Lim (UK) J Quint (UK) T: +44 (0)20 7111 1105 F Martinez (USA) E: [email protected] A Morice (UK) http://thorax.bmj.com/site/help/index.xhtml P O’Byrne (Canada) M Peters-Golden (USA) C Pison (France) Advertising E Pizzichini (Canada) Sophie Fitzsimmons A Quittner (USA) T: +44 (0)20 7383 6783 F Ratjen (Canada) E: sfi [email protected] J Scullion (UK) http://group.bmj.com/group/advertising J Simpson (UK) R Stein (Brazil) Display & Online Advertising Sales (USA) R Taylor (New Zealand) Jim Cunningham M Thomas (UK) T: +1 201 767 4170 T Treasure (UK) E: [email protected] T Troosters (Belgium) C Wainwright (Australia) D Warburton (USA) Subscription Information Author Reprints M Whyte (UK) Reprints Administrator A Woodcock (UK) Thorax is published monthly (subscribers receive all supplements) T: +44 (0)20 7383 6305 J Yorke (UK) E: [email protected] President, British Thoracic Institutional Rates Personal Rates Society 2013 2013 Ashley Woodcock Commercial Reprints (except USA & Canada) Print Print (includes online access at Nadia Gurney-Randall Production Editor £600; US$1,170; €810 no additional cost) T: +44 (0)20 8445 5825 Aimee Knight £251; US$490; €339 M: +44 (0)7866 262344 Online Journal Manager E: [email protected] Site licences are priced on FTE Online only Claire Weinberg basis and allow access by the £136; US$266; €184 Publisher whole institution. Print is ISSN 0040-6376 (print) Commercial Reprints (USA & Canada) Allison Lang available at deeply discounted ISSN 1468-3296 (online) rates for online subscribers; Marsha Fogler Guidelines for Authors and details available online at http:// T: +1 800 482 1450 (toll free in the USA) Reviewers group.bmj.com/group/subs- T: +1 856 489 4446 (outside the USA) Full instructions are available online sales/subscriptions or contact E: [email protected] at http://thorax.bmj.com/ifora. Articles the Subscription Manager in the must be submitted electronically UK (see above right). http://mc.manuscriptcentral.com/thorax. Personal print or online only and institutional print subscriptions may be British Thoracic Society Authors retain copyright but are purchased online at http://group.bmj.com/group/subs-sales/subscriptions 17 Doughty Street required to grant Thorax an (payment by (MasterCard/Visa only). London WC1N 2PL, UK T: +44 (0)20 7831 8778 exclusive licence to publish http:// Residents of some EC countries must pay VAT; for details call us or visit E: [email protected] thorax.bmj.com/ifora/licence.dtl http://group.bmj.com/group/subs-sales/subscriptions/subs-vat http://www.brit-thoracic.org.uk/index.html Impact Factor: 8.376 tthoraxjnl_68_S2_EB.inddhoraxjnl_68_S2_EB.indd 1 119/07/139/07/13 55:59:59 PPMM Charlotte E Bolton (Chair), Elaine F Bevan-Smith, John D Blakey, Patrick Crowe, Sarah L Elkin, Rachel Garrod, Neil J Greening, Karen Heslop, James H Hull, William D-C Man, Michael D Morgan, David Proud, C Michael Roberts, Louise Sewell, Sally J Singh, Paul P Walker, Sandy Walmsley The British Thoracic Society Pulmonary Rehabilitation Guideline Development Group On behalf of the British Thoracic Society Standards of Care Committee The BTS Guideline on Pulmonary Rehabilitation in Adults has been endorsed by: The Royal College of Physicians, London The Association of Chartered Physiotherapists in Respiratory Care (ACPRC) The Association of Respiratory Nurse Specialists (ARNS) The College of Occupational Therapists (COT) The Primary Care Respiratory Society – UK (PCRS-UK) tthoraxjnl_68_S2_Title_Page.inddhoraxjnl_68_S2_Title_Page.indd 1 119/07/139/07/13 55:59:59 PPMM Healthcare providers need to use clinical judgement, knowledge and expertise when deciding whether it is appropriate to apply recommendations for the management of patients. The recommendations cited here are a guide and may not be appropriate for use in all situations. The guidance provided does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer. tthoraxjnl_68_S2_Title_Page.inddhoraxjnl_68_S2_Title_Page.indd 2 119/07/139/07/13 55:59:59 PPMM Contents Volume 68 Supplement 2 | THORAX September 2013 ii1 Summary of recommendations Online Appendices Web Appendix 1: Clinical questions ii4 Introduction Web Appendix 2: Literature search details ii4 Aim Web Appendix 3: Evidence tables ii4 Target audience Web Appendix 4: Abbreviations for evidence tables Journal of the British Thoracic Society ii4 Scope Available from www.brit-thoracic.org.uk Impact Factor: 8.376 ii4 Methodology Editors Clinical questions and literature search A Bush (UK) ii4 I Pavord (UK) ii5 Appraisal of literature Deputy Editors ii5 Considered judgement and grading of evidence P Cullinan (UK) ii5 Drafting the guideline C Lloyd (UK) Associate Editors R Beasley (New Zealand) N Maskell (UK) ii6 Evidence R Buhl (Germany) S Nathan (USA) ii6 The role of pulmonary rehabilitation JC Celedón (USA) JL Pepin (France) A Custovic (UK) T Sethi (UK) ii8 Referral and assessment of patients for P Gibson (Australia) M Steiner (UK) J Grigg (UK) D Thickett (UK) pulmonary rehabilitation D Halpin (UK) A Torres (Spain) ii11 Structure of pulmonary rehabilitation A Jones (UK) Z Udwadia (India) E Lim (UK) H Zar (South Africa) ii15 Post-exacerbation pulmonary rehabilitation Statistical Editors ii16 Adjuncts to pulmonary rehabilitation J Gibson (UK) Pulmonary rehabilitation in people with other T McKeever (UK) ii19 Statistician chronic respiratory diseases L Szatkowski (UK) ii20 Post pulmonary rehabilitation Journal club Editor J Quint (UK) ii22 Summary of research President, British Thoracic Society recommendations A Woodcock Editorial Offi ce ii23 Audit BMJ Publishing Group Ltd, BMA House, Tavistock Square, London WC1H 9JR, UK T: +44 (0)20 7383 6373 ii23 Conclusions F: +44 (0)20 7383 6668 E: [email protected] ii23 References ISSN: 0040-6376 (print) ISSN: 1468-3296 (online) ii27 Appendices Disclaimer: Thorax is owned and published by the ii27 Appendix A: Committee members British Thoracic Society and BMJ Publishing Group Ltd, a wholly owned subsidiary of the British Medical ii27 Appendix B: List of stakeholders Association. The owners grant editorial freedom to ii27 Appendix C: Patient information the Editor of Thorax. Thorax follows guidelines on editorial ii27 Appendix D: Lay summary independence produced by the World Association of Medical Editors and the code on good ii29 Appendix E: Essential information required on a publication practice of the Committee on referral form to pulmonary rehabilitation Publication Ethics. Thorax is intended for medical professionals and is ii29 Appendix F: Service specifi cation provided without warranty, express or implied. Statements in the Journal are there sponsibility of ii29 Appendix G: Characteristics of rolling and their authors and advertisers and not authors’ institutions, the BMJ Publishing Group Ltd, the cohort pulmonary rehabilitation programmes British Thoracic Society or theBMAunless otherwise ii30 Appendix H: Suggested educational talks to specifi ed or determined by law. Acceptance of advertising does not imply endorsement. encompass in the pulmonary rehabilitation To the fullest extent permitted by law, the BMJ This article has been chosen by the Editor to be of special interest Publishing Group Ltd shall not be liable for any loss, programme injury or damage resulting from the use of Thorax or importance and is freely available online. or any information in it whether based on contract, tort or otherwise. Readers are advised to verify any This article has been made freely available online under the BMJ information they choose to rely on. Journals Open Access scheme. Copyright: © 2013 BMJ Publishing Group Ltd and OPEN ACCESS the British Thoracic Society. All rights reserved; no See http://thorax.bmj.com/site/about/guidelines.xhtml#open part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of Thorax. This journal is a member of and subscribes to the principles of the Thorax is published by BMJ Publishing Group Ltd, typeset by Techset and printed in the UK on Committee on Publication Ethics acid-free paper.
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