Comprehensive pulmonary rehabilitation in home-based online groups: a mixed method pilot study in COPD
Open accessAbstract
BACKGROUND: Comprehensive multidisciplinary pulmonary rehabilitation is vital in the management of chronic obstructive pulmonary disease (COPD) and is considered for any stage of the disease. Rehabilitation programmes are often centre-based and organised in groups. However, the distance from the patient's home to the centre and lack of transportation may hinder participation. Rehabilitation at home can improve access to care for patients regardless of disease severity. We had previously studied the technology usability and acceptability of a comprehensive home rehabilitation programme designed for patients with very severe COPD receiving long-term oxygen therapy. The acceptability of such comprehensive home programmes for those with less severe COPD, who may be less homebound, is not known. The aims of this feasibility study were to assess patient acceptability of the delivery mode and components of a comprehensive pulmonary rehabilitation programme for any stage of COPD, as well as the technology usability, patient outcomes and economic aspects. METHODS: Ten participants with COPD in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade I-IV were enrolled in a 9-week home programme and divided into two rehabilitation groups, with five patients in each group. The programme included exercise training and self-management education in online groups of patients, and individual online consultations. The patients also kept a digital health diary. To assess the acceptability of the programme, the patients were interviewed after the intervention using a semi-structured interview guide. In addition the number of sessions attended was observed. The usability of the technology was assessed using interviews and the System Usability Scale questionnaire. The St George's Respiratory Questionnaire (SGRQ) was used to measure health-related quality of life. RESULTS: The mode of delivery and the components of the programme were well accepted by the patients. The programme provided an environment for learning from both healthcare professionals and peers, for asking questions and discussing disease-related issues and for group exercising. The patients considered that it facilitated health-enhancing behaviours and social interactions with a social group formed among the participants. Even participants who were potentially less homebound appreciated the home group and social aspects of the programme. The participants found the technology easy to learn and use. The acceptability and usability results were consistent with those in our previous study of patients with very severe COPD. Only the mean change in the SGRQ total score of -6.53 (CI 95 % -0.38 to -12.68, p = 0.04) indicates a probable clinically significant effect. Economic calculations indicated that the cost of the programme was feasible. CONCLUSIONS: The results of this study indicate that comprehensive pulmonary rehabilitation delivered in home-based online groups may be feasible in COPD. The mode of delivery and components of the programme appeared to be acceptable across patients with different disease severity. The results in terms of patient outcomes are inconclusive, and further assessment is needed.
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Communication would be enhanced by clear communication strategies and protocols.
“would be enhanced by clear communication strategies and protocols”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Attendance rates ranged from 66% to 93.8%, with 6 studies reporting groups with rates of >80%.
“Attendance rates ranged from 66% to 93.8%, with 6 studies reporting groups with rates of >80% [32,35,36,46,47].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Eight of the 15 studies reported few technical difficulties, whereas 7 reported a number of problems, 2 of which required substantial work hours to overcome.
“Various levels of technical problems were encountered; 8 of the 15 studies reported few difficulties [31,32,34-36,38,44-46], whereas 7 reported a number of problems [33,37,39,42,43,45,47], 2 of which required substantial work hours to overcome [39,47].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Overall, inexperience with videoconferencing or computer use did not appear to be a major problem; the majority of studies reported that over time participants found the technology easy to use and enjoyable.
“Overall, inexperience did not appear to be a major problem as the majority of studies reported that, over time, participants found the technology easy to use [32-35,40-42,46] and found videoconferencing enjoyable [42,44-46].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Structure and protocols are needed to optimize group communication.
“It was acknowledged that structure and protocols are needed to optimize group communication [35].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Adherence rates were very good, with homework completed 93% of the time and all participants viewing educational videos and completing health diaries.
“Adherence rates were very good, with homework completed 93% of the time [46] and all participants viewing educational videos and completing health diaries [34,35].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
In pre-post treatment scores, there was a significant change in health-related quality of life (P=.04).
“there was a significant change in HRQoL (P=.04) [35]”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
Videoconferencing groups provided emotional and social support.
“and provided emotional and social support [32-35]”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
In one study, providing rehabilitation to home-based groups decreased costs by 50% compared with face-to-face outpatient rehabilitation.
“In one study, providing rehabilitation to home-based groups decreased costs by 50% compared with face-to-face outpatient rehabilitation [35].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [35]
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- Authors
- Burkow, T. M., Vognild, L. K., Johnsen, E., Risberg, M. J., Bratvold, A., Breivik, E., Krogstad, T., & Hjalmarsen, A.
- Affiliations
- University Hospital of North Norway (NO)
- Northern Research Institute (NO)
- Northern Norway Regional Health Authority (NO)
- UiT The Arctic University of Norway (NO)
- Corresponding author
- Burkow, Tatjana M.
- Venue
- BMC Research Notes
- Published
- 2015-12
- Volume
- 8
- Issue
- 1
- Pages
- 766-766
- ISSN
- 1756-0500 (ISSN-L)
- PMC
- PMC4674913
- OpenAlex
- W2191006514
- Cited by
- 73
- References
- 39
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 14 · 2022: 10 · 2021: 10 · 2020: 3 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 6
- FWCI
- 5.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Research Notes (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Norges Forskningsråd
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- chronic obstructive pulmonary disease, home-based pulmonary rehabilitation, patient acceptability, technology usability, exercise training, self-management education, health-related quality of life, peer support, cost feasibility, health care access, long-term oxygen therapy, St George's Respiratory Questionnaire, System Usability Scale
- MeSH terms
- Aged, Computer-Assisted Instruction, Female, Home Care Services, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Pilot Projects, Surveys and Questionnaires, Self Care, Outcome Assessment, Health Care, Telemedicine, Internet, Pulmonary Disease, Chronic Obstructive, Electronic Mail
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