Chronic obstructive pulmonary disease (COPD) rehabilitation at primary health‐care centres – the KOALA project

Background:  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).

Objectives:  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.

Methods:  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.

Results:  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.

Conclusions:  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.