Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697643047550.pdf (Australia)
Pulmonary Rehabilitation What is it like to live with a lung disease?

How do patients impact the Health System?

• Breathlessness severely impacts on daily life o Showering difficult o Making a cup of tea difficult o Walking distances difficult • Panic Attacks and Anxiety and Depression are very common • Frequent Flyers of the health system – VERY COSTLY patients and overloading some of the hospital services What is Pulmonary Rehab?
• 8 week (2-3 x per week) exercise and education program provided by specially trained health professionals • Teaches people with lung disease the skills that they need to know to stay well and out of hospital o How to manage breathlessness so they aren’t over-using medicines o How to coordinate breathing with movement so they can resume ADLs o How to clear lung secretions to reduce infections o How to cope with Anxiety, Depression and Panic Attacks o Other education: Medicines, social services, intimacy etc o Exercise is a very large component of this with a focus on endurance Is it evidence based?
• Pulmonary Rehabilitation has a large amount of NH&MRC Level I evidence to support the benefits (refer www.copdx.org.au for all evidence levels ): o Reduces hospital admissions and length of stay o Reduces re-admissions post exacerbation o o Improves symptoms of anxiety and depression Increases Quality of Life and Functional Exercise Capacity HealthSubmission 138 - Attachment 1 What have LFA and H&HSs done so far to support these programs?
• LFA supports health professionals who provide these services by: o Developing clinical resources (toolkit, action plans etc) o Pulm Rehab Network o Education and Training (Online program) to upskill people in the community to deliver programs to take the strain off the hospitals • PR is provided in the following settings: o Hospital –   IHPA Tier 2 ABF funding Focuses on the acute and complex patients with multiple high-risk co- morbidities, or those requiring access to oxygen and advanced resuscitation  This program restores people to a sufficient level of health so that they can safely participate in programs OUTSIDE the hospital environment (assuming the area has a service to refer to) o NGOs –  HACC funding limitations (doesn’t allow for <65years, ATSI <50yrs)  Organisations such as Anglicare etc o Private Providers (Physios, AEPs etc)  Currently no funding to support group exercise for respiratory disease within the MBS item numbers • Lungs in Action program developed to support ongoing weekly maintenance exercise.
No funding What still needs to be done?

• Best Solution: o Provide an MBS Item number for Physiotherapists and Exercise Physiologists to provide accredited Pulmonary Rehabilitation programs in the community o Work with LFA and other Key Stakeholders on a Lung Health strategy that incorporates COPD, bronchiectasis, pulmonary fibrosis and lung cancer as well as asthma.

HealthSubmission 138 - Attachment 1