Home respiratory rehabilitation: a purposes literature review focusing on the clinical pathway management

Abstract

Clinical Care pathways, also known as critical pathways, integrated care pathways, case management plans, clinical
care pathways or care maps, are used to systematically plan and follow up a patient focused care program. Clinical
pathways are used all over the world and so for respiratory rehabilitation pathways (RR) and the importance of
knowledge and learning Evidence Based Practice (EBP) is well known and mandatory. However, the EBP acquisitions
of the home RR model and the knowledge of Clinical Care Pathways (PCA) are poorly defined.
This study aims to conduct a narrative review of the literature to identify the content of several studies either
Randomized Controlled Trial (RCT) and Systematic Reviews (RS)
Data was extracted from the PubMed source. The RCT-RS articles selected according to the inclusion-exclusion
criteria, period 2009-2019, had as their primary focus the RR and PCA in the home setting
16 articles, out of the 1354 citations detected, met the inclusion-exclusion criteria
A total of 13 RCTs and 3 RS describe current knowledge. Elements of the home respiratory RR model are common
compared to clinical conditions such as stable, severe, very severe chronic obstructive pulmonary disease (COPD),
with hypercapnic respiratory failure and other respiratory diseases. The home RR intervention is clinically significant
for quality of life, dyspnea, exercise performance, self-sufficiency, anxiety and associated depression. PCAs in home
respiratory RR are absent. Limits were the use of a single database for research starting from 2009
In order to define the types of international and regional home respiratory treatments, given the absence of PCA in
the field, it was concluded that the variability in clinical practice of approaches and pathways limit their effectiveness.