Managing chronic obstructive pulmonary disease in primary health care: the impact of pulmonary rehabilitation


  • Dr. Guilherme Oliveira Médico Interno de Medicina Geral e Familiar. USF Esgueira +, ACeS Baixo Vouga. Aveiro, Portugal.
  • Dr.ª Rita Félix Médica Interna de Medicina Geral e Familiar. USF Fénix de Aveiro, ACeS Baixo Vouga. Aveiro, Portugal.
  • Dr. Pedro Ruivo dos Santos Médico Interno de Medicina Geral e Familiar. USF Santa Joana, ACeS Baixo Vouga. Aveiro, Portugal.
  • Dr. Luís Monteiro Assistente Graduado de Medicina Geral e Familiar. USF Esgueira +, ACeS Baixo Vouga. Aveiro, Portugal | CINTESIS – Centre for Health Technology and Services Research, Faculdade de Medicina, Universidade do Porto. Porto, Portugal | Department of Medical Sciences, University of Aveiro. Aveiro, Portugal.
  • Dr.ª Cristina Tejo Assistente Graduada de Medicina Geral e Familiar. USF Esgueira +, ACeS Baixo Vouga. Aveiro, Portugal.



Chronic obstructive pulmonary disease, Rehabilitation, Primary health care, Quality of life


Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and its management involves improving quality of life, delaying progression, and minimizing exacerbations. The benefit of pulmonary rehabilitation in COPD has been documented in the literature. This intervention can be applied to a primary healthcare setting, using community resources. 

Objectives: This systematic review sought to compile current evidence implying the impact of pulmonary rehabilitation in a primary healthcare setting on the quality of life of patients with COPD.

Methods: Three databases were searched for randomized controlled trials. We included community-based pulmonary rehabilitation and excluded interventions in a hospital setting. The primary outcome was health-related quality of life; secondary outcomes were functional exercise capacity and mortality. Data extraction and triage were performed independently by three authors, and bias was evaluated using the Cochrane Risk of Bias Tool.

Results: Four studies met the search criteria. Three studies reported benefits in at least one of the outcomes; a fourth reported no differences between groups. Rehabilitation frequency and duration seemed to have some impact on all outcomes. Mortality was higher in the control groups when available. The included studies had important limitations, namely the inability to blind interventions.

Conclusions: Pulmonary rehabilitation in a primary health care setting benefits the quality of life and functional exercise capacity in COPD patients. Optimal treatment modality, frequency, and duration are yet to be defined and are perhaps reliant on individual patient attributes. Though unable to add to previous findings, we hope this review fosters interest in this potentially life-changing intervention in a primary healthcare context.


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Como Citar

Oliveira, G., Félix, R., Ruivo dos Santos, P., ´Monteiro, L., & Tejo, C. (2024). Managing chronic obstructive pulmonary disease in primary health care: the impact of pulmonary rehabilitation. Revista Portuguesa De Medicina Geral E Familiar, 40(1), 58–67.