¿Por qué la rehabilitación respiratoria no llega a todos los pacientes de enfermedad pulmonar obstructiva crónica que lo necesitan? Revisión de la literatura

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2019-04-01

¿Por qué la rehabilitación respiratoria no llega a todos los pacientes de enfermedad pulmonar obstructiva crónica que lo necesitan? Revisión de la literatura

Why does not pulmonary rehabilitation reach all Chronic Obstructive Pulmonary Disease patients who need it? Literature review

Palabras clave:

Enfermedad pulmonar obstructiva crónica, Fisioterapia, Equidad en Salud (es)
Chronic Obstructive Pulmonary Disease, Physical Therapy Modalities, Health Equity (en)

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Autores/as

Aina Rigo Hospital de la Cruz Roja Española - Área de Intervención Social https://orcid.org/0000-0001-6156-2099
Berta Paz-Lourido Universidad de les Illes Balears - Instituto de Investigación Sanitaria Illes Balears - Grupo de Investigación en Salud Pública de las Illes Balears https://orcid.org/0000-0003-0660-4908

Resumen (es)
Resumen (en)

Introducción. La rehabilitación respiratoria (RR) es un tratamiento clave en la enfermedad pulmonar obstructiva crónica, pero aun estando disponible, los pacientes no siempre acceden a ella.

Objetivo. Identificar los factores que pueden limitar el acceso a la RR y que se relacionan con los pacientes, los médicos y los fisioterapeutas.

Materiales y métodos. Se realizó una revisión de artículos publicados en inglés y español entre 2006 y 2018. Se usaron los términos “COPD”, “chronic obstructive pulmonary disease”, “COLD”, “chronic obstructive lung disease”, “physical therapy modalities”, “rehabilitation”, “health services accessibility” y “patient” en las bases de datos PubMed, PEDro, Scielo e IBECS.

Resultados. Se seleccionaron 11 publicaciones. Entre las barreras que afectan a los pacientes destacan el transporte, la condición ambiental, las situaciones personales y algunos factores sociales y contextuales. El conocimiento de los profesionales, sus condiciones de trabajo y sus expectativas sobre beneficio de los protocolos de RR también son factores que condicionan el acceso de los pacientes.

Conclusiones. La formación interprofesional de médicos y fisioterapeutas, la implantación de protocolos flexibles a las condiciones de los pacientes y las medidas organizativas e intersectoriales del sistema sanitario pueden facilitar la accesibilidad a la RR de los pacientes.

Introduction: Pulmonary rehabilitation (PR) is a key treatment in chronic obstructive pulmonary disease, but even when available, patients do not always have access to it.

Objective: To identify factors or barriers that may limit access to PR related to patients, physicians and physiotherapists.

Materials and methods: A review of articles published in English and Spanish between 2006 and 2018 was conducted. The terms “COPD”, “chronic obstructive pulmonary disease”, “COLD”, “chronic obstructive lung disease”, “physical therapy modalities”, “rehabilitation”, “health services accessibility” and “patient” were used in the PubMed, PEDro, Scielo and IBECS databases.

Results: Eleven publications were selected. Barriers affecting patients include transportation, environmental conditions, personal situations, and some social and contextual factors. The knowledge of professionals, their working conditions and their expectations regarding the benefit of PR protocols are also factors that condition patient access.

Conclusions: The interprofessional training of physicians and physiotherapists, the implementation of flexible protocols according to patient conditions, and the organizational and intersectoral measures of the health system can facilitate accessibility to PR by patients.

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