People with chronic obstructive pulmonary disease (COPD) — a group of lung conditions mainly caused by smoking — can benefit from rehabilitation programs involving exercise and counselling, but a Canadian survey has shown there are too few of these programs to meet the demand.
The most common forms of COPD are emphysema and chronic bronchitis, which involve long-term inflammation of the breathing passages and damage to the air sacs in the lungs. Smoking causes about 90 per cent of cases, and the conditions, or related complications such as pneumonia or heart enlargement, are eventually fatal.
The survey found 98 pulmonary rehabilitation programs across the country, but there were few programs in the Maritimes and none in Prince Edward Island or Newfoundland and Labrador. Ontario had the greatest number: 24 centres offering 41 rehabilitation programs.
Given the Lung Association estimates more than 700,000 Canadians have COPD, study co-author Dr. Roger Goldstein says that not only is there a shortage of programs, but there is an issue of distribution as well.
“A treatment that we know is effective is not widely available to Canadians, who could definitely benefit from having it,” says Goldstein, who is director of the respiratory rehabilitation program at West Park Healthcare in Toronto.
Despite the lack of availability, the study found program quality was topnotch, with all involving physical exercise of one kind or another. “COPD rehabilitation is really a combination of exercise, education and psychological support,” Goldstein says. “The goal is to improve quality of life by improving functional capacity.”
He says increasing the number of programs would not be difficult. “The key is to bring this right into the communities where the patients live, rather than ask the ministry of health for more money for hospital-based programs.”
In addition, Goldstein says doctors and patients alike need to be more aware that these programs exist. “If you had a heart attack, it would be almost unthinkable that you didn’t go to a cardiac rehabilitation program. COPD doesn’t enjoy the same profile. There’s a certain stigma still in the minds of the public to an extent that, because this is caused by smoking, people have done this to themselves.”