Australian and New Zealand Pulmonary Rehabilitation Guidelines
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Background and objective: The aim of the PulmonaryRehabilitation Guidelines (Guidelines) is to provideevidence-based recommendations for the practice ofpulmonary rehabilitation (PR) speciﬁc to Australianand New Zealand healthcare contexts.Methods: The Guideline methodology adhered to theAppraisal of Guidelines for Research and Evaluation(AGREE) II criteria. Nine key questions were con-structed in accordance with the PICO (Population,Intervention, Comparator, Outcome) format andreviewed by a COPD consumer group for appropriate-ness. Systematic reviews were undertaken for eachquestion and recommendations made with the strengthof each recommendation based on the GRADE(Gradings of Recommendations, Assessment, Develop-ment and Evaluation) criteria. The Guidelines wereexternally reviewed by a panel of experts.Results: The Guideline panel recommended thatpatients with mild-to-severe COPD should undergo PRto improve quality of life and exercise capacity and toreduce hospital admissions; that PR could be offered inhospital gyms, community centres or at home and couldbe provided irrespective of the availability of a struc-tured education programme; that PR should be offeredto patients with bronchiectasis, interstitial lung disease and pulmonary hypertension, with the latter in special-ized centres. The Guideline panel was unable to makerecommendations relating to PR programme lengthbeyond 8 weeks, the optimal model for maintenance afterPR, or the use of supplemental oxygen during exercisetraining. The strength of each recommendation and thequality of the evidence are presented in the summary.Conclusion: The Australian and New Zealand PulmonaryRehabilitation Guidelines present an evaluation of theevidence for nine PICO questions, with recommendationsto provide guidance for clinicians and policymakers.
Copyright 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Paciﬁc Society of Respirology. This is an open access article under the terms of the CreativeCommons Attribution-NonCommercial License, which permitsuse, distribution and reproduction in any medium, provided theoriginal work is properly cited and is not used for commercialpurposes.
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