Evaluate the patient’s biopsychosocial status

A comprehensive evaluation is necessary for every patient who is referred to a pulmonary rehabilitation program. It should include a medical, psychological and social evaluation.

A physician usually does the medical evaluation. A detailed medical history and the patient's current medical condition are necessary to determine if the patient can participate in the exercises that are part of a pulmonary rehabilitation program. Certain conditions or comorbidities could affect the patient's capacity to engage in such a program (depression, any severe or unmanageable medical problem, significant cognitive disorders).

The medical evaluation will also provide valuable information that will help better personalize the education sessions. The medical evaluation can be initiated or completed by a nurse. The evaluation must not only include the medical aspects stated above, but also a psychosocial evaluation.

Bio-psychosocial evaluation

• Shortness of breath
  MRC scale
  Respiratory disorder questionnaires
  Other questionnaires: CRQ; BDI/TDI

• Anxiety/depression
  Geriatric depression scale
  Hospital Anxiety and Depression (HAD) Scale (FR)

• Comorbidities
• Smoking
• HLifestyle (exercise, nutrition and sleep routines)

Evaluation of the pharmacological treatment

An up-to-date pharmacological profile has to be drawn up for each patient who wants to embark upon a pulmonary rehabilitation program. To this end, the patient should provide a list of the medication they are taking when they undergo their medical evaluation. Compliance with the pharmacological treatment must also be evaluated at this time. If the information is not available in the patient's dossier (from the hospital), it's possible to directly contact the pharmacy and find out whether there has been or not compliance with the treatment, judging by the renewal of the patient's prescriptions.