P18 Community-based pulmonary rehabilitation in patients with pulmonary hypertension: a feasibility study

Background Evidence shows improvements in exercise capacity and quality of life following exercise rehabilitation in patients with pulmonary hypertension (PH). To date, studies have focused primarily on in-patient rehabilitation regimes, which may not be accessible to all patients, and are unavailable in many national health systems including the UK. Community-based pulmonary rehabilitation is effective in improving exercise capacity and quality of life in patients with COPD, but its use has not been investigated in patients with PH. Aims and objectives To investigate the feasibility of using community-based pulmonary rehabilitation (CBPR) programmes for patients with pulmonary hypertension (PH). Methods Patients attending a PH Specialist Centre who were established on targeted drug therapy for at least 3 months, were seen by a physiotherapist specialising in PH. Functional ability, levels of physical activity, limitations and goals were identified, and rehabilitation potential was clinically assessed. Suitable patients were referred for CBPR and follow up phone calls were made to monitor progress. Results Of 151 patients assessed by the specialist physiotherapist: 44% (n=66) accepted referrals to CBPR, 6% (n=9) declined. 50% (n=76) were considered unsuitable for CBPR and offered alternative supportive or therapeutic interventions. Of 66 patients referred for CBPR (55 Pulmonary Arterial Hypertension, 7 Chronic Thromboembolic PH, 4 other PH), within 6 months of referral: 38% (n=25) had completed their rehabilitation, 11% (n=7) had started rehabilitation and were ongoing, while 11% (n=7) were waiting to start. 22% (n=17) withdrew from rehabilitation before completion. 9% (n=7) passed away before starting rehabilitation and 4% (n=3) were lost to follow up. Waiting times from referral to starting CBPR ranged from 1 month to 10 months, with a mean of 4 months. No adverse events were reported by patients or therapists conduction rehabilitation. Conclusions Community-based pulmonary rehabilitation is feasible in patients with PH with high levels of uptake by patients and no significant adverse events reported. Lengthy waiting times to start CBPR are common, and their impact on completion of rehabilitation programmes warrants further investigation. Further work is required to assess the efficacy and cost effectiveness of CBPR in patients with PH.