Mobile Pulmonary Rehabilitation: Feasibility of Delivery by a Mobile Phone-Based Program

Abstract

Background: Pulmonary rehabilitation (PR) has been proven effective but is not well accessed due to transport, time, cost, and physical limitations of patients. We have developed a mobile phone-based PR program (mPR) that could be offered as an alternative for those unable to attend in-person. This was developed following formative research with patients, their families and clinicians. mPR has a core text message program plus an app that includes an action plan, exercise videos, lung visualization, symptom score questionnaire and 1-min sit-to-stand test.Aims: To determine the feasibility of delivering pulmonary rehabilitation by mobile phone.Methods: A 9-week non-randomized (1-arm) pilot study was conducted. Participants were 26 adults with chronic obstructive pulmonary disease plus four family members, who were offered participation at first assessment or during group PR sessions. Outcomes included satisfaction, engagement with the program, and perceived impacts.Results: Eight people (31%) opted for text messages only, and 18 (69%) chose text messages plus the app. Three people stopped the program early, 20 said they would recommend it to others, 19 said it helped them to feel more supported, 17 said it helped them to change their behavior.Conclusion: It is feasible to deliver PR support via mobile phone, including exercise prescription and support. Our mPR program was appreciated by a small number of people with chronic respiratory disorders and family members. Suggestions for improvements are being used to inform the further development of the program, which will then be tested for effectiveness. Registered with the Australia New Zealand Clinical Trials Registry ACTRN12619000884101 (www.anzctr.org.au).

The Impact of Patient Preference on Attendance and Completion Rates at Centre-Based and mHealth Pulmonary Rehabilitation: A Non-Inferiority Pragmatic Clinical Trial

“…9,10 A mHealth PR programme (mPR) was developed in 2019 for use in Aotearoa New Zealand (NZ) context by our team of public health and mHealth experts, physiotherapists, respiratory physicians, psychologists, respiratory nurse specialists, cultural experts, and ongoing input from end users. 11,12 The feasibility of this programme has been demonstrated for people living with CRD in NZ. 12 Patients have preferences for how they receive rehabilitation programmes; 13,14 however, an important limitation in PR clinical trials to date is that they do not account for patient preferences for mode of delivery [13][14][15][16] .…”

“…11,12 The feasibility of this programme has been demonstrated for people living with CRD in NZ. 12 Patients have preferences for how they receive rehabilitation programmes; 13,14 however, an important limitation in PR clinical trials to date is that they do not account for patient preferences for mode of delivery [13][14][15][16] . Several home-based trials of PR have reported low uptake due to participant's preference for centre-based PR.…”

“… 9 , 10 A mHealth PR programme (mPR) was developed in 2019 for use in Aotearoa New Zealand (NZ) context by our team of public health and mHealth experts, physiotherapists, respiratory physicians, psychologists, respiratory nurse specialists, cultural experts, and ongoing input from end users. 11 , 12 The feasibility of this programme has been demonstrated for people living with CRD in NZ. 12 …”

“… 11 , 12 The feasibility of this programme has been demonstrated for people living with CRD in NZ. 12 …”

Evaluation of m‐Health‐rehabilitation for respiratory disorders: A systematic review

“…Pulmonary rehabilitation is a comprehensive therapeutic intervention for patients with respiratory disorders, 3 which is effective in improving their quality of life. 4 Pulmonary rehabilitation is defined as “a comprehensive intervention based on a thorough patient assessment followed by patient‐tailored therapies that include but are not limited to, exercise training, education, and behavior change designed to improve the physical and psychological condition of people with chronic respiratory disease and promote the long‐term adherence to health‐enhancing behaviors.” 5 The benefits of pulmonary rehabilitation do not last over time and gradually disappear between 6 and 12 months after the end of pulmonary rehabilitation. Lack of commitment to rehabilitation seems to be one of the possible reasons for losing these benefits.…”