Global RECHARGE: Establishing a standard international data set for pulmonary rehabilitation in low- and middle-income countries

Abstract

Chronic respiratory diseases (CRD) are highly prevalent in low- and middle-income countries (LMICs). People living with CRD are often disabled by breathlessness which can result in reduced health-related quality of life, including reduced exercise tolerance, significant psychological morbidity and reduced ability to work. Implementing clinically and cost-effective interventions to tackle these problems can be challenging in low-resource settings. Pulmonary rehabilitation is a low cost, high impact intervention that reverses CRD-related disability and is supported by the highest level of re-search. Pulmonary rehabilitation is delivered by a multidisciplinary team and has exercise training and education at its core to support effective disease management and improve people’s quality of life. There is an unmet need for pulmonary rehabilitation that is profound in LMICs where the demand greatly outweighs the capacity. The sparse existence of pulmonary rehabilitation in LMICs offers an important opportunity to support the expansion of high quality, benchmarked services as it becomes increasingly recognised and available. Quality assurance procedures for pulmonary rehabilitation in the developed world are now in place; helping to ensure a high standard of patient care. In this paper we discuss a common data set that has been developed by the NIHR Global Health Research Group on Respiratory Rehabilitation (Global RECHARGE). Standardising data collection with a pre-determined set of measurements is proposed whereby collaborators will use common data col-lection tools and procedures. Benchmarking and quality improvement with continuous audit offer a potential to maximise benefits, reduce waste and improve patient outcomes. We welcome expressions of interest from health care professionals and researchers from LMICs, including groups looking to strengthen their local research capacity and from those looking to set up pulmonary rehabilitation through to those already running a service. We believe the wide adoption of this core data set will facilitate quality assurance of pulmonary rehabilitation programmes, provide opportunities to expand services over time, de novo research opportunities offered by trans-national data and enhanced research capacity in partner organisations