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Title: Multimorbidity, frailty and chronic obstructive pulmonary disease: Are the challenges for pulmonary rehabilitation in the name?
Austin Authors: Holland, Anne E ;Harrison, Samantha L;Brooks, Dina
Affiliation: Institute for Breathing and Sleep
Department of Physiotherapy, Alfred Health, Melbourne, Australia
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada..
Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
Health and Social Care Institute, Teesside University, UK
Issue Date: Nov-2016 2016-10-26
Publication information: Chronic respiratory disease 2016; 13(4): 372-382.
Abstract: The overwhelming majority of people with chronic obstructive pulmonary disease (COPD) have at least one coexisting medical condition often conceptualized as 'comorbidities'. These coexisting conditions vary in severity and impact; it is likely that for some patients, COPD is not their most important or severe condition. The concepts of multimorbidity and frailty may be useful to understand the broader needs of people with COPD undergoing pulmonary rehabilitation. Multimorbidity describes the coexistence of two or more chronic conditions, without reference to a primary condition. Best care for people with multimorbidity has been described as a shift from providing disease-focused to patient-centred care. Pulmonary rehabilitation is well placed to deliver such care as it focuses on optimizing function, encourages integration across care settings, values input from multidisciplinary teams and measures patient-important outcomes. When designing optimal pulmonary rehabilitation services for people with multimorbidity, the concept of frailty may be useful. Frailty focuses on impairments rather than medical conditions including impairments in mobility, strength, balance, cognition, nutrition, endurance, mood and physical activity. Emerging data suggest that frailty may be modifiable with pulmonary rehabilitation. The challenge for pulmonary rehabilitation clinicians is to broaden our perspective on the role and outcomes of pulmonary rehabilitation for people with multimorbidity.
DOI: 10.1177/1479972316670104
ORCID: 0000-0003-2061-845X
Journal: Chronic respiratory disease
PubMed URL: 30209972
PubMed URL:
Type: Journal Article
Subjects: Chronic obstructive pulmonary disease
pulmonary rehabilitation patient-centred care
Appears in Collections:Journal articles

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