Jan W H Custers, Martijn Vooijs, Erik Bergkamp, Daniel Langer, Cor A. M. Zagers, Jean W M Muris, Eleonore H Koolen, Anne-Loes van der Valk, Maurice J.H. Sillen, Hester van der Vaart, Guus A. Meerhoff, Maria H. T. Post, Johan B. Wempe, Mitchell van Doormaal, Alex J van 't Hul, Jos Donkers, Dirk van Ranst, Sami O. Simons, Renée van Snippenburg, Eline Bij de Vaate, Marleen Bregman, Daisy J.A. Janssen, Hilde L. Vreeken, Ingrid M. L. Augustin, Leendert Tissink, Emmylou Beekman, Martijn A. Spruit, Frits F. M. Franssen, Jeanine Antons, Philip J. van der Wees, Sarah Houben-Wilke, Pulmonologie, RS: NUTRIM - R3 - Respiratory & Age-related Health, Epidemiologie, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, Family Medicine Education, RS: CAPHRI - R5 - Optimising Patient Care, Health Services Research, RS: CAPHRI - R1 - Ageing and Long-Term Care, MUMC+: MA Med Staf Spec Longziekten (9), van 't Hul, Alex/0000-0002-5514-2327, SPRUIT, Martijn A., Van't Hul, Alex, Vreeken, Hilde L., Beekman, Emmylou, Post, Maria H. T., Meerhoff, Guus A., Van der Valk, Anne-Loes, Zagers, Cor, Sillen, Maurice J. H., Vooijs, Martijn, Custers, Jan, Muris, Jean, Langer, Daniel, Donkers, Jos, Bregman, Marleen, Tissink, Leendert, Bergkamp, Erik, Wempe, Johan, Houben-Wilke, Sarah, Augustin, Ingrid M. L., de Vaate, Eline Bij, Franssen, Frits F. M., Van Ranst, Dirk, Van der Vaart, Hester, Antons, Jeanine, Van Doormaal, Mitchell, Koolen, Eleonore H., van der wees, philip, Van Snippenburg, Renee, Janssen, Daisy J. A., and Simons, Sami
A loss of physical functioning (i.e., a low physical capacity and/or a low physical activity) is a common feature in patients with chronic obstructive pulmonary disease (COPD). To date, the primary care physiotherapy and specialized pulmonary rehabilitation are clearly underused, and limited to patients with a moderate to very severe degree of airflow limitation (GOLD stage 2 or higher). However, improved referral rates are a necessity to lower the burden for patients with COPD and for society. Therefore, a multidisciplinary group of healthcare professionals and scientists proposes a new model for referral of patients with COPD to the right type of exercise-based care, irrespective of the degree of airflow limitation. Indeed, disease instability (recent hospitalization, yes/no), the burden of disease (no/low, mild/moderate or high), physical capacity (low or preserved) and physical activity (low or preserved) need to be used to allocate patients to one of the six distinct patient profiles. Patients with profile 1 or 2 will not be referred for physiotherapy; patients with profiles 3-5 will be referred for primary care physiotherapy; and patients with profile 6 will be referred for screening for specialized pulmonary rehabilitation. The proposed Dutch model has the intention to get the right patient with COPD allocated to the right type of exercise-based care and at the right moment. Spruit, MA (corresponding author), CIRO, Dept Res & Dev, Horn, Netherlands; Maastricht Univ, Dept Resp Med, Med Ctr MUMC, Maastricht, Netherlands; NUTRIM Sch Nutr & Translat Res Metab, Maastricht, Netherlands; Hasselt Univ, Fac Rehabil Sci, REVAL Rehabil Res Ctr, BIOMED Biomed Res Inst, Diepenbeek, Belgium. martijnspruit@ciro-horn.nl