Role of digital health in pulmonary rehabilitation and beyond: shaping the future

Abstract

Pulmonary rehabilitation (PR) is a cost-effective intervention with well-known benefits on exercise capacity, symptoms and quality of life in patients with chronic respiratory diseases. Despite the compelling evidence of its benefits, PR implementation is still suboptimal, and maintenance of PR benefits is challenging. To overcome these pitfalls, there has been a growing interest to develop novel models for PR delivery. Digital health is a promising solution, as it has the potential to address some of the most reported barriers to PR uptake and adherence (such as accessibility issues), help maintain the positive results following a PR programme, and/or promote patients’ adherence to a more active lifestyle through physical activity (tele-)coaching. Despite the accelerated use of digital health to deliver PR during the COVID-19 pandemic, there are still several factors that contribute to the resistance in the adoption of digital health, such as the lack of evidence on its effectiveness, low acceptability by patients and healthcare professionals, concerns about implementation and maintenance costs, inequalities in access to the internet and technological devices, and data protection issues. Nevertheless, the trend towards reducing technology costs and the higher availability of digital devices, as well as the greater ease and simplicity of use of devices, enhance the opportunities for future development of digitally enabled PR interventions. This narrative review aimed to examine the current evidence on the role of digital health in the context of PR, including strengths and weaknesses, and to determine possible threats and opportunities, as well as areas for future work.

An Update of Cardiopulmonary Rehabilitative Measures in Long-COVID-19 Patients: A Systematic Review

“…This aligns with the long-established role of pulmonary rehabilitation in managing chronic respiratory conditions [24]. Additionally, the role of telecoaching in enhancing the effects of homebased pulmonary rehabilitation programs is notable, especially considering the importance of remote healthcare delivery in the ongoing pandemic scenario [25]. However, more highquality studies are needed to assess the longterm effects and the optimal duration of these interventions.…”

Digital Health from the Eyes of Hospital Managers

“…Örneğin; Japonya telekomünikasyon ağları aracılığıyla, yaşlıların evlerinde elde ettiği yaşamsal verileri tıbbi kurumlara bağlamaktadır. Bu sayede, kullanıcılar yaşam tarzlarını koruyarak daha kısa sürelerde tedavi edilmekte, bu ise sonuç olarak sadece tıp merkezleri için değil, hastalar için de maliyetlerin azaltılmasına izin vermektedir 12 13 . Özel hastanelerin dijitalleşme süreci ile ilgili yönetici görüşlerinin ortaya çıkarılması amacıyla yapılan başka bir nitel araştırma sonucunda da hastanelerin dijitalleşmesinin, her türlü verinin elektronik olarak kaydedilmesi, veri güvenliğinin sağlanması, Sağlık Bilgi Sistemine ve güncel son teknoloji cihazlara sahip olma şeklinde güçlü yanları olduğu belirlenmiştir 18 .…”

Efficacy and safety of a music-therapy facilitated pulmonary telerehabilitation program in COPD patients: the COPDMELODY study protocol

“…However, recent guidelines support the development of home-based PR, telehealth, and mHealth interventions in which objective, timely, and reliable monitoring of treatment implementation is deemed important. Remote technologies and wearable activity trackers could strengthen contact with patients, increase participation rates, and long-term adherence to healthy behaviors (34). Furthermore, although the digital literacy of patients with COPD is considered a barrier to PR participation, data from a recent study revealed encouraging results with the successive use of smartphones and wearable technology by an older respiratory population (35).…”