Australian and New Zealand Pulmonary Rehabilitation Guidelines
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McKeough, ZJ
Johnston, K
McNamara, RJ
Spencer, LM
Jenkins, SC
Hill, CJ
McDonald, VM
Frith, P
Cafarella, P
Brooke, M
Cameron-Tucker, HL
Candy, S
Cecins, N
Chan, ASL
Dale, MT
Dowman, LM
Granger, C
Halloran, S
Jung, P
Lee, AL
Leung, R
Matulick, T
Osadnik, C
Roberts, M
Walsh, J
Wootton, S
Holland, AE
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Abstract
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.
Journal Title
Respirology
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22
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4
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© 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Paci?c 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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Biomedical and clinical sciences