Design and delivery of home-based telehealth pulmonary rehabilitation programs in COPD: A systematic review and meta-analysis

Michaelchuk, Wade; Oliveira, Ana Irene Alves de; Marzolini, Susan; Nonoyama, Mika; Maybank, Aline; Goldstein, Roger; Brooks, Dina

doi:10.1016/j.ijmedinf.2022.104754

Cited by 30 publications

(29 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 38 Increased use of telehealth technologies for pulmonary rehabilitation or remote consultations, likely to have been accelerated by the COVID-19 pandemic, are also providing additional options for care models. 39 , 40 There is a need for a multidisciplinary approach across all stages of the pathway, there is no point in diagnosing patients earlier if they then cannot be appropriately treated or access effective non-pharmacological interventions.…”

Section: Discussionmentioning

confidence: 99%

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Meiwald¹,

Gara-Adams²,

Rowlandson³

et al. 2022

COPD

View full text Add to dashboard Cite

Background Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. A comprehensive and detailed understanding of COPD care pathways from pre-diagnosis to acute care is required to understand the common barriers to optimal COPD care across diverse health systems. Methods Country-specific COPD care pathways were created for four high-income countries using international recommendations and country-specific guidelines, then populated with published epidemiological, clinical, and economic data. To refine and validate the pathways, semi-structured interviews using pre-prepared discussion guides and country-specific pathway maps were held with twenty-four primary and secondary care respiratory healthcare professionals. Thematic analysis was then performed on the interview transcripts. Results The COPD care pathway showed broad consistency across the countries. Three key themes relating to barriers in optimal COPD management were identified across the countries: journey to diagnosis, treatment, and the impact of COVID-19. Common barriers included presentation to healthcare with advanced COPD, low COPD consideration, and sub-optimal acute and chronic disease management. COVID-19 has negatively impacted disease management across the pathway but presents opportunities to retain virtual consultations. Structural factors such as insurance and short duration of appointments also impacted the diagnosis and management of COPD. Conclusion COPD is an important public health issue that needs urgent prioritization. The use of Evidenced Care Pathways with decision-makers can facilitate evidence-based decision making on interventions and policies to improve care and outcomes for patients and reduce unnecessary resource use and associated costs for the healthcare provider/payer.

show abstract

Section: Discussionmentioning

confidence: 99%

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Meiwald¹,

Gara-Adams²,

Rowlandson³

et al. 2022

COPD

View full text Add to dashboard Cite

show abstract

“…Specifically, a strict telemonitoring of COPD patient parameters might promote an early therapeutic intervention crucially affecting the risk of exacerbations. Moreover, digital innovation might improve exercise program delivery, might improve education of both patients and caregivers, and might support behavior changes with potential benefits in physical function and HR-QOL [ 46 , 185 , 186 , 187 ]. In this context, the RCT by Rutkowski et al [ 188 ] introduced a virtual reality approach to improve PR delivery in patients with chronic pulmonary diseases, reporting several advantages of this approach.…”

Section: Sustainable Strategies and Digital Innovationmentioning

confidence: 99%

Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

Sire

Lippi

Aprile

et al. 2022

JPM

View full text Add to dashboard Cite

Osteoporosis is a highly prevalent condition affecting a growing number of patients affected by chronic obstructive pulmonary disease (COPD), with crucial implications for risk of fragility fractures, hospitalization, and mortality. Several risk factors have been identified to have a role in osteoporosis development in COPD patients, including corticosteroid therapy, systemic inflammation, smoke, physical activity levels, malnutrition, and sarcopenia. In this scenario, a personalized multitarget intervention focusing on the pathological mechanisms underpinning osteoporosis is mandatory to improve bone health in these frail patients. Specifically, physical exercise, nutritional approach, dietary supplements, and smoke cessation are the cornerstone of the lifestyle approach to osteoporosis in COPD patients, improving not only bone health but also physical performance and balance. On the other hand, pharmacological treatment should be considered for both the prevention and treatment of osteoporosis in patients at higher risk of fragility fractures. Despite these considerations, several barriers still affect the integration of a personalized approach to managing osteoporosis in COPD patients. However, digital innovation solutions and telemedicine might have a role in optimizing sustainable networking between hospital assistance and community settings to improve bone health and reduce sanitary costs of the long-term management of COPD patients with osteoporosis.

show abstract

“…However, other disease-specific online interventions have reported challenges with recruiting, retaining and engaging patients [ 33 ]. It must be acknowledged that during the COVID-19 pandemic, online delivery of both the educational and exercise components of pulmonary rehabilitation have demonstrated positive outcomes [ 34 ]. In contrast to disease specific interventions, SELF-BREATHE is a transdiagnostic online supportive self-management intervention for individuals living with chronic breathlessness due to advanced disease, supporting individuals during daily life and at the point of breathlessness crisis.…”

Section: Discussionmentioning

confidence: 99%

“The whole of humanity has lungs, doesn't it? We are not all the same sort of people”: patient preferences and choices for an online, self-guided chronic breathlessness supportive intervention: SELF-BREATHE

et al. 2022

View full text Add to dashboard Cite

IntroductionThe burden of chronic breathlessness on individuals, family, society, and health systems is significant and set to increase exponentially with an ageing population with complex multimorbidity, yet there is a lack of services. This has been further amplified by the COVID-19 pandemic. Online breathlessness interventions have been proposed to fill this gap, but need development and evaluation based on patient preferences and choices.AimThis study aimed to explore preferences and choices of patients regarding the content of an online self-guided chronic breathlessness supportive intervention (SELF-BREATHE).MethodsSemi-structured telephone interviews were conducted with adults living with advanced malignant and non–malignant disease and chronic breathlessness (July–November 2020). Interviews were analysed using conventional and summative content analysis.Results25 patients with advanced disease and chronic breathlessness [(COPD: 13, lung cancer: 8, ILD: 3, bronchiectasis: 1), 17 male, median age 70 years (range 47–86), MRC Dyspnoea score 3 (2 −5)] were interviewed. Individuals highlighted strong preferences for focused education, methods to increase self-motivation and engagement, interventions targeting breathing and physical function, software capability to personalise the content of SELF-BREATHE to make it more meaningful to the user, and aesthetically designed content using various communication methods including written, video and audio content. Furthermore, they identified the need to address motivation as a key potential determinant of the success of SELF-BREATHE.ConclusionOur findings provide an essential foundation for future digital intervention development (SELF-BREATHE) and scaled research.

show abstract

Design and delivery of home-based telehealth pulmonary rehabilitation programs in COPD: A systematic review and meta-analysis

Cited by 30 publications

References 61 publications

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Qualitative Validation of COPD Evidenced Care Pathways in Japan, Canada, England, and Germany: Common Barriers to Optimal COPD Care

Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

“The whole of humanity has lungs, doesn't it? We are not all the same sort of people”: patient preferences and choices for an online, self-guided chronic breathlessness supportive intervention: SELF-BREATHE

Contact Info

Product

Resources

About