The feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease
| Autor: | Jack Middleton, Matthew Bland, Adam Lewis, Kate McCrum, Elaine Bevan-Smith, Ellena Knight, Esther Mitchell, Joy Conway |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_treatment Anxiety Pulmonary Disease Chronic Obstructive 0302 clinical medicine Quality of life Telerehabilitation 030212 general & internal medicine Aged 80 and over Exercise Tolerance Depression Middle Aged emphysema Treatment Outcome Medicine Female medicine.symptom Pulmonary and Respiratory Medicine Occupational therapy medicine.medical_specialty mixed methods Context (language use) service evaluation Diseases of the respiratory system 03 medical and health sciences medicine Humans COPD Pulmonary rehabilitation Hydrotherapy Physical Therapy Modalities online Aged Asthma Internet RM695_Physical RC705-779 SARS-CoV-2 business.industry COVID-19 medicine.disease pulmonary rehabilitation Respiratory Research 030228 respiratory system Quality of Life Physical therapy Feasibility Studies Lung Diseases Interstitial business |
| Zdroj: | BMJ Open Respiratory Research BMJ Open Respiratory Research, Vol 8, Iss 1 (2021) |
| ISSN: | 2052-4439 |
| Popis: | Copyright © Author(s) (or their employer(s)) 2021. 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 semi-structured interviews were completed with PR staff and participants. Results Twenty-five individuals were eligible from a PR waiting list. Thirteen declined participation and fourteen completed PR. Significant Pre-post online PR improvements were achieved in 1-minute sit-to-stand (Confidence interval (CI) 2.1 - 9 (p = 0.004)), Generalised Anxiety Disorder (CI -0.3 - -2.6(p = 0.023)), Primary Health Questionnaire-9 (CI -5.1 - -0.3 (p = 0.029)), Chronic Respiratory Questionnaire dyspnoea (CI 0.5 - 1.3 (p = 0.001)), Fatigue (CI 0.7 - 2 (p = 0.0004)), Emotion (CI 0.7 - 1.7 (p = 0.0002)), Mastery (CI 0.4 - 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 to 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, 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. The University of Gloucestershire, Sport, Exercise, Health and Wellbeing Internal Research Grant Programme 2019-2020 The University of Gloucestershire, Sport, Exercise, Health and Wellbeing Internal Research Grant Programme 2019-2020, for £8047. |
| Databáze: | OpenAIRE |
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