Asthma is highly prevalent and associated with high morbidity and mortality. It affects 30–50 million people in Europe, often starting in infancy and persisting throughout life. Asthma is a major global health challenge, affecting more than 300 million people worldwide and at least 10% of all Europeans [1]. People with asthma live at risk of life-threatening asthma attacks, leading to over 500 000 hospitalisations each year. Approximately 5–10% of asthma cases are so severe that current treatments do not work. The Framework Programme 7-funded European Asthma Research and Innovation Partnership (EARIP; www.EARIP.eu) was established in 2013 to harmonise efforts to reduce mortality and morbidity from asthma by agreeing the most important research priorities across relevant stakeholders in Europe. This is essential to address the significant impact of asthma on the individual, healthcare systems and national and European economies, outlined in the accompanying editorial in this issue of the European Respiratory Journal [2]. EARIP produced an evidence- and consensus-based list of the research priorities (a “roadmap”) and investment needed to reduce asthma deaths and hospitalisations. By identifying the priorities, a coordinated effort can be made to fast-track change to better manage, prevent and cure asthma [3]. The roadmap will be the foundation on which future EU, national and international research funding programmes can transform asthma outcomes throughout Europe. The roadmap is the product of a comprehensive multi-stage process, led by the European Lung Foundation and Asthma UK (figure 1) [4]. Multiple stakeholder groups informed the roadmap process to ensure scientific accuracy, clinical relevance and outcomes that reflect the priorities of patients and caregivers, with an overarching steering board. A final consensus workshop brought together 28 experts from 15 European countries comprising: patients, patient organisations, primary healthcare professionals (HCPs), secondary HCPs, researchers, industry representatives and policy influencers. A full list of the roadmap contributors is available at www.EARIP.eu/roadmap. The rest of this article describes its development and outcomes

Pulmonary rehabilitation (PR) improves functional capacity, health-related quality of life (HRQoL) in COPD patients, and maintenance programmes are relevant in preserving those improvements. However, little is known about the structure of maintenance programmes after PR. We performed a systematic review and meta-analysis of experimental and quasi-experimental studies evaluating individuals with COPD admitted to a maintenance PR programme, delivered after an initial PR programme. We reported functional capacity evaluation (6-minute-walking-test), HRQoL, dyspnoea and symptom control. Searches were performed on the 11th April 2021 using MEDLINE, Embase, EBSCO, CINAHL, Web of Science and Cochrane Library. We extracted summary-level data from trial publications and used a random-effects model, predicting that severe heterogeneity was detected. The protocol was registered in PROSPERO (CRD42021247724). Fifteen studies were included in the meta-analysis, with 1151 participants. Maintenance programmes were associated with a pooled mean increase of 27.08 meters in 6mWT (CI: 10.39 to 43.77; I2 = 93%; p < 0.0001), being better in supervised, long (>12 month) home-based programmes; and having a potential MD of -4.20 pts in SGRQ (CI: -4.49 to -3.91; I2 = 0%; p = 0.74). Regarding dyspnoea and exacerbations, we found a nonsignificant trend for improvement after maintenance PR programmes. Severe COPD patients showed smaller improvements in programmes up to a year. Overall, the strength of the underlying evidence was moderate. Despite limitations of risk of bias and heterogeneity, our results support that home-based, supervised, long-term maintenance PR programmes may significantly improve functional capacity in COPD patients and HRQoL.

A Reabilitação Respiratória é o tratamento não farmacológico indicado para pessoas com DPOC, tendo o exercício físico e a educação para a saúde centrados no desenvolvimento do autocuidado e autogestão, promovendo a condição física, emocional, a adesão ao regime terapêutico e qualidade de vida. Pretende-se demonstrar a efetividade de um programa de RR domiciliária. Método: Estudo de caso quantitativo que decorreu ao longo de 8 semanas, com intervenção multidisciplinar bissemanal, com recurso ao treino de exercício físico, sessões de educação e acompanhamento telefónico. Foi realizada avaliação funcional na admissão e alta, utilizando os instrumentos Questionário Clínico para a DPOC, Teste sentar e levantar (T S&L) e Índice de Barthel. Resultados: Homem de 70 anos, diagnóstico de DPOC, realizou 16 sessões de treino presencial como planeado. Apresentou evolução funcional significativa: CCQ inicial 4.5, final 3.2; T S&L inicial 5, final 14; Índice de Barthel inicial 55, final 90. Conclusão: O programa de reabilitação respiratória delineado demonstrou efetividade e segurança, promovendo uma melhoria funcional significativa. Palavras-chave: Reabilitação respiratória; DPOC; Reabilitação respiratória domiciliária; Enfermagem de Reabilitação