Innovative strategies to improve the reach and engagement in pulmonary rehabilitation

Abstract

Evidence of personal and health-system benefits of pulmonary rehabilitation are undeniable.However, the capacity of traditional centre-based models to both reach and appeal to the intended population of people living with chronic obstructive pulmonary disease (COPD) remains difficult. It is well established that issues with access, suitability, referral, uptake, and attrition exist. Consequently, considerable energy has been invested into exploring innovative alternative modes of rehabilitation in an effort to increase the awareness and appeal, and expand the availability of pulmonary rehabilitation. The process of 'thinking differently' and 'pushing the boundaries' of clinical practice is underway, particularly in the United Kingdom and Australia, where new models of pulmonary rehabilitation are being evaluated. The number one priority is reaching the population of people with COPD and ensuring they are referred to rehabilitation services.Active case-finding in primary care, inviting health professionals and health consumers to pulmonary rehabilitation programs to increase understanding and awareness, and utilizing peer support via patient success stories, are just a few suggestions for increasing awareness of pulmonary rehabilitation. Once referred, engaging the population to complete a program is the next challenge. Marketing, patient co-design, alternative rehabilitation settings and modes of exercise training, use of technology, and focusing on modes which provide patient enjoyment and choice are all potential strategies to target in an effort to broaden the appeal and reduce the high attrition rate of traditional centre-based pulmonary rehabilitation programs. Reaching and engaging the target population in pulmonary rehabilitation is an important first step in people with COPD achieving successful outcomes from rehabilitation.

Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study

“…On the other hand, positive changes in depression scores did not seem to be influenced after the respiratory rehabilitation program. This is in line with the findings of McNamara [17] et al who reported that 6-9 weeks of respiratory rehabilitation did not improve depression in elderly patients with COPD. The above results need to be further confirmed by samples and longer respiratory rehabilitation studies.…”

COVID-19 Rehabilitation With Herbal Medicine and Cardiorespiratory Exercise: Protocol for a Clinical Study

“…A further aim is to preserve physical function while improving health-related QoL in the long term. As recommended by the Official American Thoracic Society/European Respiratory Society Statement [20], 12 education sessions (30 minutes per session) will be included in and delivered together with the first exercise session in each week to motivate and empower the patients to form regular exercise habits and improve health [21,22]. A steering group will be formed to design the exercise intervention, develop relevant documentation, and monitor the implementation.…”

“…Some evidence, although not for COVID-19, has suggested that home-based pulmonary rehabilitation with minimal exercise equipment is effective and may be a viable alternative to equipment-intensive clinic-based programs [18,26]. Other studies concluded that the web-based tele-exercise approaches were as effective as conventional face-to-face interventions [27] and could enhance the reach and engagement of the rehabilitation process [21,25]. We will build and develop a web-based platform in our International Rehabilitation Network Center for Patients With COVID-19 to deliver the intervention.…”

“…In terms of intensity of resistance training, a practical approach to determine the appropriate intensity will be adopted, in which workloads will be set at levels that evoke local muscular exhaustion in 6 to 12 repetitions, as the one repetition maximum approach may overestimate or underestimate the optimal resistance for individuals [20,31]. Progressive target goals and detailed training plans will be set up together with each patient based on their physiological measurement results [21].…”

Early home-based pulmonary rehabilitation following acute exacerbation of COPD: A feasibility study using an action research approach

“… 6 Alternative PR models have been proposed to enhance program uptake in people with stable COPD. 9 The home-based model of PR is one such alternative, demonstrated to be safe and to deliver similar benefits to outpatient, centre-based, PR in people with stable COPD. 10 A nested qualitative study reported that participants felt well supported and the home-based program could fit in with their daily lives.…”