Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review

Oliveira, Túlio Medina Dutra de; Pereira, Adriano Luiz; Costa, Giovani Bernardo; Mendes, Liliane; Almeida, Leonardo Barbosa de; Velloso, Marcelo; Malaguti, Carla

doi:10.3389/fresc.2022.780736

Cited by 6 publications

(3 citation statements)

References 90 publications

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“…Nevertheless, most research into COPD hospitalization prevention is still focused on treatment in a hospital ( 17 ). In line with other studies, our findings call for increased attention to and capacity for treating COPD patients outside the hospital system ( 55 – 57 ). In our study, the reimbursement data indicated that there was no increase in GP care despite the increased use of physiotherapy care.…”

Section: Discussionsupporting

confidence: 92%

Intensive out-of-hospital coaching for frequently hospitalized COPD patients: a before-after feasibility study

Noort,

van der Vaart,

van der Maten

et al. 2023

Front. Med.

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BackgroundThis study assesses whether out-of-hospital coaching of re-hospitalized, severe COPD patients by specialized respiratory nurses is feasible in terms of cost-effectiveness, implementation, and recipient acceptability. The coaching was aimed at improving patients’ health management abilities, motivation for healthy behavior, strengthening the professional and informal care network, stimulating physiotherapy treatment and exercise training, improving knowledge on symptom recognition and medication use, and providing safety and support.MethodsCost-effectiveness of 6 months of out-of-hospital coaching was assessed based on a before-after intervention design, with real-life data and one-year follow-up. A total of 170 patients were included. Primary (questionnaires, meeting reports) and secondary data (insurance reimbursement data) were collected in one province in the Netherlands. The implementing and recipient acceptability was assessed based on the number of successfully delivered coaching sessions, questionnaire response rate, Patient Reported Experience Measure, and interviews with coaches.ResultsPost-intervention, the COPD-related hospitalization rate was reduced by 24%, and patients improved in terms of health status, anxiety, and nutritional status. Patients with a high mental burden and a poor score for health impairment and wellbeing at the start of the intervention showed the greatest reduction in hospitalizations. The coaching service was successfully implemented and considered acceptable by recipients, based on patient and coach satisfaction and clinical use of patient-reported measures.ConclusionThe study demonstrates the value of coaching patients out-of-hospital, with a strong link to primary care, but with support of hospital expertise, thereby adding to previous studies on disease- or self-management support in either primary or secondary care settings. Patients benefit from personal attention, practical advice, exercise training, and motivational meetings, thereby improving health status and reducing the likelihood of re-hospitalization and its associated costs.

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Section: Discussionsupporting

confidence: 92%

Intensive out-of-hospital coaching for frequently hospitalized COPD patients: a before-after feasibility study

Noort,

van der Vaart,

van der Maten

et al. 2023

Front. Med.

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“…The diversity of telerehabilitation delivery models also creates heterogeneity in programme components. This includes the type and amount of clinician supervision of exercise training, for example real-time supervision versus asynchronous supervision/oversight; individually prescribed and progressed exercise training or self-paced training; the nature and degree of communication between patients and healthcare professionals, for example two-way verbal communication through to patient-initiated asynchronous, written correspondence; the amount and complexity of equipment required for telerehabilitation delivery, for example fixed telephone versus internet-enabled device with or without videoconferencing capabilities; and minimal low cost or specialist exercise training equipment [46]. It is likely that the optimal delivery model for telerehabilitation may vary according to resources available and patient characteristics.…”

Section: Models and Evidence For Telerehabilitationmentioning

confidence: 99%

Telerehabilitation in pulmonary diseases

Cox

Khor

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewTelerehabilitation is an alternative delivery model for pulmonary rehabilitation, an evidence-based nonpharmacological intervention, in people with chronic pulmonary disease. This review synthesizes current evidence regarding the telerehabilitation model for pulmonary rehabilitation with an emphasis on its potential and implementation challenges, as well as the clinical experiences from the COVID-19 pandemic.Recent findingsDifferent models of telerehabilitation for delivering pulmonary rehabilitation exist. Current studies comparing telerehabilitation to centre-based pulmonary rehabilitation primarily focus on the evaluation in people with stable chronic obstructive pulmonary disease, which demonstrated equivalent improvements in exercise capacity, health-related quality of life and symptoms with improved programme completion rates. Although telerehabilitation may improve access to pulmonary rehabilitation by addressing travel burden, improving schedule flexibility and geographic disparity, there are challenges of ensuring satisfaction of healthcare interactions and delivering core components of initial patient assessment and exercise prescription remotely.SummaryFurther evidence is needed on the role of telerehabilitation in various chronic pulmonary diseases, as well as the effectiveness of different modalities in delivering telerehabilitation programmes. Economic and implementation evaluation of currently available and emerging models of telerehabilitation in delivering pulmonary rehabilitation are needed to ensure sustainable adoption into clinical management for people with chronic pulmonary disease.

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“…PR is the gate to reduce COPD symptoms, and to improve exercise capacity and overall quality of life [ 6 ]. However, COPD patients face difficulties in accessing traditional PR services, whether due to high costs, limited infrastructure, lack of interest, and, even if they start PR, there is generally a poor adherence rate to PR programmes [ 6 , 7 , 8 ]. A recent prospective multicentre cohort study found that only 1% of patients hospitalised with COPD exacerbation utilised PR after discharge, with no in-hospital interventions associated with increased PR use [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Digital Health Interventions for Pulmonary Rehabilitation in People with COPD: A Systematic Review of Randomized Controlled Trials

Aburub,

Darabseh,

Badran

et al. 2024

Medicina

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Background and Objectives: Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of death globally. Pulmonary rehabilitation (PR) programmes are important to reduce COPD symptoms and improve the quality of life of people with COPD. Digital health interventions have recently been adopted in PR programmes, which allow people with COPD to participate in such programmes with low barriers. The aim of this study is to review and discuss the reported effects of digital health interventions on PR outcomes in people with COPD. Materials and Methods: To achieve the study goals, a systematic literature search was conducted using PubMed (MEDLINE), CINAHL, AMED, SPORTDiscus and the Physiotherapy Evidence Database. Randomised clinical trials (RCTs) were included if they met specified criteria. Two reviewers independently checked titles, abstracts, and performed full-text screening and data extraction. The quality assessment and risk of bias were performed in accordance with the PEDRO scale and Cochrane Risk of Bias tool 2, respectively. Results: Thirteen RCTs were included in this systematic review with 1525 participants with COPD. This systematic review showed the potential positive effect of digital health PR on the exercise capacity—measured by 6- and 12-min walking tests, pulmonary function, dyspnoea and health-related quality of life. There was no evidence for advantages of digital health PR in the improvement of anxiety, depression, and self-efficacy. Conclusions: Digital health PR is more effective than traditional PR in improving the pulmonary and physical outcomes for people with COPD, but there was no difference between the two PR programmes in improving the psychosocial outcomes. The certainty of the findings of this review is affected by the small number of included studies.

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Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review

Cited by 6 publications

References 90 publications

Intensive out-of-hospital coaching for frequently hospitalized COPD patients: a before-after feasibility study

Intensive out-of-hospital coaching for frequently hospitalized COPD patients: a before-after feasibility study

Telerehabilitation in pulmonary diseases

The Effects of Digital Health Interventions for Pulmonary Rehabilitation in People with COPD: A Systematic Review of Randomized Controlled Trials

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