Comparison of telehealth versus centre-based pulmonary rehabilitation in clinical practice

ABSTRACT

Introduction/Aim: The COVID-19 pandemic has led to implementation of telehealth pulmonary rehabilitation (PR), which remains a favourable alternative to the traditional centre-based model in jurisdictions where the risk of patient vulnerability to COVID-19 is high. This study compares the outcomes between telehealth PR and centre-based PR in people with chronic respiratory disease. Methods: Retrospective data were collected between December 2020 and October 2021 from chronic respiratory disease patients who undertook 6-8 weeks of either twice weekly supervised centre-based PR or telehealth PR involving once-weekly telephone/video calls from an experienced clinician guiding patients on home-based exercise. Telehealth PR was the default model of care, with centrebased PR only offered if telehealth was not possible due to safety, feasibility or previous failure of telehealth PR or if patients (ILD only) agreed to participate in a specific research project that involved centre-based attendance. Outcomes included functional capacity, dyspnoea, health related quality of life (HRQoL) and global rating of change. Results: Thirty-two patients undertook centre-based PR (age 70(8) years, ILD = 20(63%), COPD = 9(28%), other = 3 (9%)) and 32 patients undertook telehealth PR (age 72(12), COPD = 20(63%), ILD = 7(22%), other = 5(15%)). There were no significant differences between groups for functional capacity, dyspnoea or HRQoL (Table 1). However, a greater proportion of patients perceived their overall condition had improved following telehealth PR (63% vs. 47%, p = 0.009). Both groups achieved significant improvements in HRQoL at end rehabilitation. Significant improvement in functional capacity following PR was seen only in the centre-based group (n = 29), although this outcome was only available in 12 (38%) telehealth PR patients. Conclusion: Telehealth PR produces improvements in functional capacity and HRQoL that are equivalent to centre based PR and is associated with a perceived overall benefit by a greater proportion of participants. Telehealth PR is a suitable alternative to the standard centre-based approach telerehabilitation may not be equivalent to centre-base. (Figure Presented).