Feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease

Lewis, Adam, Knight, Ellena, Bland, Matthew, Middleton, Jack, Mitchell, Esther, McCrum, Kate, Conway, Joy and Bevan-Smith, Elaine ORCID: 0000-0002-9636-5367 (2021) Feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease. BMJ Open Respiratory Research, 8 (1). e000880. doi:10.1136/bmjresp-2021-000880

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Abstract

Introduction SARS-CoV- 2 has restricted access to face-to- face delivery of pulmonary rehabilitation (PR). Evidence suggests that telehealth-PR is non-inferior to outpatient PR. However, it is unknown whether patients who have been referred to face-to- face programmes can feasibly complete an online-PR programme. Methods This service evaluation used a mixed-methods approach to investigate a rapid PR service remodelling using the University of Gloucestershire eLearn Moodle platform. Quantitative baseline demographic and PR outcome data were collected from online-PR participants, and semistructured interviews were completed with PR staff and participants. Results Twenty-five individuals were eligible from a PR waiting list. Thirteen declined participation and 14 completed PR. Significant pre-post online PR improvements were achieved in 1 min sit-to- stand (CI 2.1 to 9 (p=0.004)), Generalised Anxiety Disorder (CI −0.3 to −2.6 (p=0.023)), Primary Health Questionnaire-9 (CI −0.3 to −5.1 (p=0.029)), Chronic Respiratory Questionnaire dyspnoea (CI 0.5 to 1.3 (p=0.001)), fatigue (CI 0.7 to 2 (p=0.0004)), emotion (CI 0.7 to 1.7 (p=0.0002)), mastery (CI 0.4 to 1.3 (p=0.001)). Interviews indicated that patient PR inclusion was made possible with digital support and a PR introduction session improved participant engagement and safety. Incremental progression of exercise was perceived as more successful online compared with face-to- face PR. However, perceptions were that education sessions were less successful. Online-PR required significant staff time resource. Discussion Online-PR improves patient outcomes and is feasible and acceptable for individuals referred for face-to- face PR in the context of a requirement for social distancing. Face-to- face programmes can be adapted in a rapid fashion with both staff and participants perceiving benefit. Future pragmatic trials are now warranted comparing online-PR including remote assessments to centre-based PR with suitably matched outcomes, and patient and staff perceptions sought regarding barriers and facilitators of online delivery.

Item Type: Article
Article Type: Article
Uncontrolled Keywords: Online rehabilitation; Chronic respiratory disease; Pulmonary rehabilitation
Subjects: R Medicine > RM Therapeutics. Pharmacology > RM695 Physical medicine. physical therapy including massage, exercise, occupational therapy, hydrotherapy, phototherapy, radiotherapy, thermotherapy, electrotherapy
Divisions: Schools and Research Institutes > School of Health and Social Care > Allied Health Professions
Research Priority Areas: Society and Learning
Depositing User: Susan Turner
Date Deposited: 25 Mar 2021 13:00
Last Modified: 25 Mar 2021 13:15
URI: http://eprints.glos.ac.uk/id/eprint/9507

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