Combined lung and heart rehabilitation dramatically improves outcomes, research shows

An innovative approach to rehabilitation for people with both lung disease and heart failure dramatically improved mental and physical health, compared to separate programmes, a Derbyshire research study has found.

NHS Derby and Derbyshire funded Derbyshire Community Health Services NHS Foundation Trust to conduct the study with people who had both heart failure and chronic obstructive pulmonary disease (COPD).

Eight patients who had been diagnosed with both COPD and heart failure took part in the exercise and education programme over 10 weeks during autumn 2024 at Walton Hospital in Chesterfield.

Traditionally these patients receive separate rehabilitation from teams dedicated to lung and to heart rehabilitation.

But, the researchers said, people are often affected by both conditions and the rehabilitation programmes are similar for both.

They also provided a holistic programme that focused on addressing physical, psychological, and educational needs.

By combining the programmes they found:

• symptoms of depression improved by 40%
• reported anxiety improved too, so 85% of patients reported normal anxiety levels
• people were able to undertake exercise better and improved their ability to walk and their grip strength
• patients reported weight loss, in some cases of up to 5kg or 6kg during the course of the rehabilitation programme
• 88% of patients completed the programme – way above the 50% national average for cardia rehabilitation and 60% for pulmonary rehabilitation

The researchers also found:

• patients valued the holistic approach, stating it helped them better understand their conditions
• the social aspect of group rehabilitation increased motivation and participation
• patients felt the programme was tailored to meet their individual needs

They recommend:

• repeating the study in another area of Derbyshire and increasing the numbers of participants
• widening the criteria for acceptance onto the programme so it becomes more inclusive
• addressing staffing and financial issues so the programme can be rolled out further and generate efficiencies and better patient outcomes

Sianna Murphy led the project, together with Kerry Howkins, lead clinical pulmonary physiotherapist and Robert Holehouse, technical instructor.

Sianna will present the findings at the European Association of Cardiac Nursing and Allied Professionals in France this June before publication in the European Journal of Cardiovascular Nursing.

She said: “Research has shown the strong link between the risks of COPD and the risks of cardiovascular disease, but traditionally rehabilitation for these two conditions has been done separately.

“The NHS Long Term Plan has drawn together services, resources, and leadership to collaboratively provide comprehensive care, expanding the range of options available to our patients.

“This pilot has shown significant benefits in patient outcomes, attendance, and engagement.

“This approach also reduces duplication, making it more cost-effective for the trust while ensuring holistic care is provided to meet patients’ needs.

“A single, streamlined programme also increases patient commitment by reducing the time spent in two stand-alone programmes.

“We believe that expanding and refining the programme could provide a cost-effective, efficient, and scalable solution for managing patients with multiple long-term conditions.”