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King J.1, Tessier S.1, Charette M.-J.1, Gaudet D.1
1University of Ottawa, Physiotherapy, Ottawa, Canada
Background: Unfortunately chronic obstructive pulmonary disease (COPD) affects people worldwide. Physiotherapists have been acknowledged to play an integral and vital role in the care of people living with COPD. International guidelines recommend that patient education (PE) geared towards self-management be included in all pulmonary rehabilitation programs for patients with COPD. Yet we know very little about issues critical to the wide spread provision and overall effectiveness of this PE including the role of different health care professionals, including physiotherapists (PTs).
Purpose: The purpose of this scoping review was to identify and map out current knowledge related to the provision and effectiveness of PE provided by PTs for people living with COPD.
Methods: Using scoping review guidelines by Arksey and OMalley (2005) and Levac (2010) searches of CINAHL, Education Source, EMBASE, Medline, PEDro and PsycINFO databases were conducted. 447 articles were identified using keywords. Their titles and abstracts were further screened for inclusion criteria of; adults (18 years or older) living with COPD, published in English or French between 1995 and 2015 and indication that PTs were involved in providing PE. 14 studies were found that matched the inclusion criteria. Key data extraction for each article included
1) participant characteristics
2) study type
3) patient education interventions
4) educator
5) outcome measures and
6) study results.
Results: The severity of participants COPD varied between studies. The majority of the studies were randomized controlled trials investigating different models of PE as components of pulmonary rehabilitation interventions. Common PE topics included anatomy and physiology of COPD, stress management, energy conservation, exacerbations and breathlessness and exercise. Both PTs and nurses provided PE to patients in the majority of studies. Although the studies had positive results for the pulmonary rehabilitation interventions, none of the studies included specific outcome measures to evaluate the effectiveness of the PE component of these interventions.
Conclusion(s): The scoping review identified a number of gaps in the literature that must be addressed to ensure that patients receive the most effective PE to help them manage their COPD. There is ambiguity in the literature regarding what part of the PE program is being provided specifically by the physiotherapist, what education topics should and are being delivered by the physiotherapist as well as how physiotherapists are delivering this PE in an effective manner to patients with COPD. Further studies are needed to identify best practices for both the content and the delivery methods of PE interventions for people living with COPD by PTs.
Implications: Even though PE is routinely provided by PTs to people living with COPD throughout the world, often as part of interprofessional teams, the results of this scoping review found that our unique role and contributions are not well defined. As well unfortunately the heterogeneity of the studies prevents any specific evidence based recommendations to be given to PTs to guide them in providing the most effective PE to people living with COPD to optimize their quality of life.
Funding acknowledgements: none
Topic: Cardiorespiratory
Ethics approval: As this study was a scoping review of academic literature and not directly involving patients, no ethical approval was needed.
All authors, affiliations and abstracts have been published as submitted.
