Barriers and enablers of COPD telerehabilitation &amp;ndash; a frontline staff perspective

Damhus, Christina Sadolin; Emme, Christina; Hansen, Henrik

doi:10.2147/copd.s167501

Cited by 50 publications

(90 citation statements)

References 43 publications

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“…Although the numbers of HCPs using mHealth interventions are growing, studies focusing solely on the frontline staff perspective on mHealth are limited [36,46]. Some of the findings presented in this study confirm findings that have been reported previously in the context of mHealth for COPD management.…”

Section: Discussionsupporting

confidence: 84%

“…We used the same sampling strategy for the remaining professions, with similar saturation points and continuing to interview the 10 participants for each profession. Our final sample size was comparable with similar qualitative studies [30,36,37].…”

Section: Methodssupporting

confidence: 82%

“…Some of the findings presented in this study confirm findings that have been reported previously in the context of mHealth for COPD management. As Damhus et al [36] noted, HCPs reported technical issues as a major challenge for mHealth adoption. Our findings are in agreement with Vorrink et al [47], who stress the importance of training patients and HCPs on the proper use of mHealth.…”

Section: Discussionmentioning

confidence: 99%

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Perceptions of Health Care Providers Regarding a Mobile Health Intervention to Manage Chronic Obstructive Pulmonary Disease: Qualitative Study

Alwashmi

FitzPatrick

Davis

et al. 2019

JMIR Mhealth Uhealth

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Background Using a mobile health (mHealth) intervention, consisting of a smartphone and compatible medical device, has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes while mitigating health care costs. Objective The aim of this study was to explore the potential facilitators and barriers among health care providers (HCPs) regarding the use of mHealth interventions for COPD management. Methods This was a qualitative study. Semistructured individual interviews were conducted with HCPs, including nurses, pharmacists, and physicians who work directly with patients with COPD. A flexible prompts guide was used to facilitate discussions. Interview topics included the following: demographics, mHealth usage, perceptions toward challenges of mHealth adoption, factors facilitating mHealth adoption, and preferences regarding features of the mHealth intervention for COPD management. Interviews were conversational in nature, and items were not asked verbatim or in the order presented. The interviews were transcribed verbatim and compared against the digital recordings to ensure the accuracy of the content. After creating a codebook for analysis, 2 researchers independently coded the remaining interview data using pattern coding. They discussed commonalities and differences in coding until a consensus was reached. Results A total of 30 nurses, physicians, and pharmacists participated. The main facilitators to mHealth adoption are possible health benefits for patients, ease of use, educating patients and their HCPs, credibility, and reducing cost to the health care system. Alternatively, the barriers to adoption are technical issues, privacy and confidentiality issues, lack of awareness, potential limited uptake from the elderly, potential limited connection between patients and HCPs, and finances. Conclusions It is important to understand the perceptions of HCPs regarding the adoption of innovative mHealth interventions for COPD management. This study identifies some potential facilitators and barriers that may inform the successful development and implementation of mHealth interventions for COPD management.

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Section: Discussionsupporting

confidence: 84%

Section: Methodssupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perceptions of Health Care Providers Regarding a Mobile Health Intervention to Manage Chronic Obstructive Pulmonary Disease: Qualitative Study

Alwashmi

FitzPatrick

Davis

et al. 2019

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…We developed it using patients’ and professionals’ opinions through coproduction; we wanted the most effective use of skills and often limited resources (staff and hospital space); we did “what is needed, no more, no less”; we were very keen to reduce inappropriate local variation where large rural areas have no access to PR 14. We involved staff in the development and implementation of technology alongside technology providers within healthcare, and kept the technology as simple as possible to minimize technical issues 22…”

Section: Discussionmentioning

confidence: 99%

<p>Safety, feasibility, and effectiveness of virtual pulmonary rehabilitation in the real world</p>

Knox¹,

Dunning²,

Davies³

et al. 2019

COPD

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Purpose To assess the feasibility, safety, and effectiveness of a VIrtual PulmonAry Rehabilitation (VIPAR) program in a real-world setting. Patients and methods Twenty-one patients with stable chronic lung disease at a spoke site received (VIPAR) through live video conferencing with a hub where 24 patients were receiving 14 sessions of standard, outpatient, multi-disciplinary pulmonary rehabilitation (PR) in a hospital. We studied three such consecutive PR programs with 6–10 patients at each site. The hub had a senior physiotherapist, occupational therapist, exercise assistant, and guest lecturer, and the spoke usually had only an exercise instructor and nurse present. Uptake, adverse events (AEs), and early clinical changes were compared within and between groups. Travel distances were estimated using zip codes. Results Mean attendance was 11.0 sessions in the hub and 10.5 sessions in the spoke ( P =0.65). There was a single (mild) AE (hypoglycemia) in all three hub programs and no AEs in the three spoke programs. Mean COPD Assessment Test scores improved from 25.3 to 21.5 in the hub ( P <0.001, 95% CI 2.43–5.17) and from 23.4 to 18.8 ( P <0.001, 2.23–7.02) in the spoke group, with no difference between the groups ( P =0.51, −3.35–1.70). Mean incremental shuttle walk test scores improved from 142 to 208 m ( P <0.001, 75–199) in the hub and from 179 to 316 minutes in the spoke ( P <0.001, 39.3–92.4), with a greater improvement in the spoke ( P =0.025, 9.31–133). Twenty-one patients saved a total of 8,609.8 miles over the three programs by having the PR in their local spoke, rather than traveling to the usual nearest (hospital) hub. Conclusion Video-conferencing, which links a local site to a standard PR program is feasible, safe, and demonstrates at least equivalent short-term clinical gains. Throughput can be increased, with less staffing ratios and significantly less traveling.

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“…Briefly, the TDF is a comprehensive framework of theoretical domains including individual (rational, cognitive, emotional) and external, organizational variables (working environment, resources) that influence behavioral change and innovation uptake. The TDF has been widely used to inform implementation of interventions in respiratory research and clinical practice [ 19 – 21 ].…”

Section: Methodsmentioning

confidence: 99%

Factors influencing the implementation and uptake of a discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease: a qualitative focus group study

Michas

Deuchar

Leigh

et al. 2020

Implement Sci Commun

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Background: Chronic obstructive pulmonary disease (COPD) is one of the most common causes of mortality and morbidity in high-income countries. In addition to the high costs of initial hospitalization, COPD patients frequently return to the emergency department (ED) and are readmitted to hospital within 30 days of discharge. A COPD acute care discharge care bundle focused on optimizing care for patients with an acute exacerbation of COPD has been shown to reduce ED revisits and hospital readmissions. The aim of this study was to explore and understand factors influencing implementation and uptake of COPD discharge care bundle items in acute care facilities from the perspective of health care providers and patients. Methods: Qualitative methodology was adopted. Nine focus groups were conducted using a semi-structured guide: seven with acute and primary/community health care providers and two with patients/family members. Focus groups were audiotaped, transcribed verbatim, and coded and analyzed using a thematic approach. Results: Forty-six health care providers and 14 patients/family members participated in the focus groups. Health care providers and patients identified four factors that can challenge the implementation of COPD discharge care bundles: process of care complexities, human capacity in care settings, communication and engagement, and attitudes and perceptions towards change. Both health care providers and patients recognized process of care complexity as the most important determinant of the COPD discharge bundle uptake. Processes of care complexity include patient activities in seeking and receiving care, as well as practitioner activities in making a diagnosis and recommending or implementing treatment. Important issues linked to human capacity in care settings included time constraints, high patient volume, and limited staffing. Communication during transitions in care across settings and patient engagement were also broadly discussed. Other important issues were linked to patients', providers', and system attitudes towards change and level of involvement in COPD discharge bundle implementation.

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Barriers and enablers of COPD telerehabilitation – a frontline staff perspective

Cited by 50 publications

References 43 publications

Perceptions of Health Care Providers Regarding a Mobile Health Intervention to Manage Chronic Obstructive Pulmonary Disease: Qualitative Study

Perceptions of Health Care Providers Regarding a Mobile Health Intervention to Manage Chronic Obstructive Pulmonary Disease: Qualitative Study

<p>Safety, feasibility, and effectiveness of virtual pulmonary rehabilitation in the real world</p>

Factors influencing the implementation and uptake of a discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease: a qualitative focus group study

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