Document resource
Background Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure (HF) share symptoms such as breathlessness and reduced exercise tolerance.Patients with both conditions often attend separate rehabilitation services, reducing opportunities of enhanced holistic care and increasing the potential for conflicting information.The NHS Long Term Plan promotes integrated, patient-centred models for complex multimorbidity, yet combined pulmonary and cardiac rehabilitation (PR/CR) remains underexplored.Aim To evaluate the feasibility and impact of a 10-week integrated PR/CR programme, focusing on holistic outcomes, multidisciplinary collaboration, and patient involvement.Methods Eight patients with confirmed dual diagnoses of COPD and HF were identified through referrals and jointly assessed.The programme included co-developed exercise and education sessions. Patients influenced service design through questionnaires, focus groups, and weekly feedback’ leading to iterative improvements.Outcome measures included CRDQ, LINQ, physiological data, and clinical interventions. Baseline and discharge assessments were compared against national benchmarks for standalone PR and CR.Results Integrated care enabled timely, holistic interventions. Cardiac patients received respiratory reviews, inhaler optimisation, COPD care planning, and bone density assessments. Respiratory patients benefited from cardiac medication titration, GTN prescribing, echocardiograms, and secondary prevention input.CRDQ outcomes exceeded national PR averages (2018), with emotional and mastery scores more than doubling. LINQ scores fell by 4.6, indicating improved self-management.Joint education, supported by the Recap Health App, enables personalised online education packages with videos, improved accessibility, tracking engagement, and gathering feedback, vital given the local population’s average reading age of nine.Attendance averaged 74%, with 88% completion, both surpassing national benchmarks. Patients reported increased confidence and satisfaction, with 100% recommending the service.The programme met national PR and CR quality standards for accreditation.Abstract P43 Figure 1Comparative chart showing CRDQ outcomes for PR 2018 (light grey) versus PR/C. Pilot Programme (dark grey). The chart highlights improvements in mastery and emotional scores over the national averagesConclusions Integrated PR/CR is effective, feasible, and potentially scalable. It enhances access, eliminates duplication, and supports personalised care, aligning with NHS priorities.Results demonstrate marked improvements in confidence and mental health over standalone programmes.This innovative rehabilitation programme fosters collaboration across specialist areas to deliver a truly holistic approach to care. Unlike anything currently offered in the UK, it responds directly to patient feedback, highlighting a clear demand for integrated support.Further testing is needed on a larger scale.