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A systematic review of the content and delivery of education in pulmonary rehabilitation programmes

Roberts, N.J.; Kidd, L.; Kirkwood, K.; Cross, J.; Partridge, M.R.


L. Kidd

K. Kirkwood

J. Cross

M.R. Partridge


Pulmonary rehabilitation (PR) is a core component of Chronic Obstructive Pulmonary Disease (COPD) management with well recognized benefits. While suggestions for educational content within pulmonary rehabilitation have been detailed in clinical guidance, it is unclear what educational content is delivered as part of pulmonary rehabilitation, who delivers it, and how it is delivered.

A systematic review was conducted to identify what educational content is delivered as part of pulmonary rehabilitation, how is this delivered and who delivers it. Databases were searched from 1981 to 2017 using multiple search terms related to “pulmonary rehabilitation” and “education”.

Fourteen studies were identified. This included 6 survey studies, 5 quasi-experimental studies and 3 RCTs. Five key topics that were consistently included within PR programmes were identified as:

1) Anxiety/depression and stress management.
2) Early recognition of signs of infection.
3) Dyspnea and symptom management.
4) Nutrition.
5) Techniques using inhalers and nebulizers.

Broader topics such as welfare/benefits, sexuality, and advance care directives did not frequently feature. Only four studies used tools to measure knowledge or learning pre and post rehabilitation in an attempt to evaluate the effectiveness of the education delivered as part of PR.

The delivery of education in PR programmes is variable and does not follow suggested educational topics. Education needs to take a patient centered motivational approach to ensure effective delivery. Further research into appropriate educational outcome measures are needed, in order to evaluate the changes in behaviour associated with education.

Journal Article Type Article
Acceptance Date Nov 2, 2018
Online Publication Date Nov 5, 2018
Publication Date 2018-12
Deposit Date Aug 30, 2022
Journal Respiratory Medicine
Print ISSN 0954-6111
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 145
Pages 161-181
Keywords Pulmonary rehabilitation, Education, Patient-centred care, Respiratory disease, Delivery of care
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