Non-Pharmacological Treatments of Asthma Chronic Obstructive Pulmonary Disease Overlap and Rehabilitation Programs

Non-pharmacologic treatment is a vital, yet often under-utilized aspect of care for patients with ACO. As patients with ACO are often excluded from clinical trials, management decisions should be based on patient characteristic "phenotypes," such as dyspnea or exacerbation, and considering whether COPD or asthma is more pronounced in the individual patient. Self-management interventions in asthma and COPD have an overwhelming amount of supporting evidence and should be an integral part of ACO management. Additionally, pulmonary rehabilitation has widespread benefits in patients with COPD as well as asthma and should be offered in symptomatic patients with ACO. While the COVID-19 pandemic has highlighted some shortcomings, and introduced several challenges, to the delivery of PR world-wide, it has also presented the opportunity for the development and refinement of new models to deliver PR, such as telerehabilitation. While further research and development are necessary, telerehabilitation offers a promising alternative to reach patients, such as those with ACO, who would benefit from the programming. While future research is needed, we can make a more explicit and judicious use of current best evidence in making therapeutic decisions that includes non-pharmacological interventions in patients with ACO.