Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline.
Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline.
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DOI：
10.1164/rccm.202306-1066st
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发表时间：
2023-08-15
影响因子：
24.7
通讯作者：
中科院分区：
文献类型：
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作者：
尽管肺康复（PR）对慢性呼吸系统疾病患者的益处是众所周知的，但这种治疗尚未得到充分利用。循证指南应使人们更多地了解PR的已证实益处，强调PR在循证医疗保健中的作用，从而促进慢性呼吸道疾病患者的转诊和更有效的PR治疗。多学科小组制定了六个研究问题，解决特定患者群体（慢性阻塞性肺疾病[COPD]，间质性肺病和肺动脉高压）的PR和PR交付模型（远程康复，维持PR）。使用系统评价对治疗效果进行量化。建议、评估、制定和评价方法的分级用于制定临床建议。专家组作出以下判断：对于稳定期COPD成人患者，强烈建议PR（中等质量证据）和COPD急性加重住院后（中等质量证据），强烈建议间质性肺病成人患者PR（中等质量证据），有条件推荐肺动脉高压成人患者PR（低质量证据），强烈建议为慢性呼吸系统疾病患者提供基于中心的PR或远程康复选择（中等质量证据），并有条件地建议为COPD成人患者提供监督维持PR或初始PR后的常规护理（低质量证据）。这些指南为慢性呼吸道疾病患者提供了循证PR的基础。
Despite the known benefits of pulmonary rehabilitation (PR) for patients with chronic respiratory disease, this treatment is underused. Evidence-based guidelines should lead to greater knowledge of the proven benefits of PR, highlight the role of PR in evidence-based health care, and in turn foster referrals to and more effective delivery of PR for people with chronic respiratory disease. The multidisciplinary panel formulated six research questions addressing PR for specific patient groups (chronic obstructive pulmonary disease [COPD], interstitial lung disease, and pulmonary hypertension) and models for PR delivery (telerehabilitation, maintenance PR). Treatment effects were quantified using systematic reviews. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to formulate clinical recommendations. The panel made the following judgments: strong recommendations for PR for adults with stable COPD (moderate-quality evidence) and after hospitalization for COPD exacerbation (moderate-quality evidence), strong recommendation for PR for adults with interstitial lung disease (moderate-quality evidence), conditional recommendation for PR for adults with pulmonary hypertension (low-quality evidence), strong recommendation for offering the choice of center-based PR or telerehabilitation for patients with chronic respiratory disease (moderate-quality evidence), and conditional recommendation for offering either supervised maintenance PR or usual care after initial PR for adults with COPD (low-quality evidence). These guidelines provide the basis for evidence-based delivery of PR for people with chronic respiratory disease.
影响因子：
2.6
作者：
Cascino TM;Ashur C;Richardson CR;Jackson EA;McLaughlin VV
通讯作者：
McLaughlin VV