The Multi-morbidity Patient (chapter 35).

The patients with chronic obstructive pulmonary disease (COPD) are elderly and complex individuals with comorbidities (multi-morbidity COPD), that reflect the coexistence of other medical conditions alongside their established lung and airways impairment. The identification of these associated conditions represents an important step towards the characterization of the patients’ disabilities and to an appropriate referral for comprehensive rehabilitation. The literature suggests that the number of comorbidities does not affect adherence or outcomes of pulmonary rehabilitation in multi-morbidity COPD patients. Notwithstanding, specific coexisting conditions may have a peculiar impact on the extent of the gains provided by the rehabilitation course. To optimize rehabilitation, clinicians should be aware of any specific needs associated with complex multi-morbidity COPD patients.