Telehealth pulmonary rehabilitation: A review of the literature and an example of a nationwide initiative to improve the accessibility of pulmonary rehabilitation

Abstract

Several different applications of telehealth technologies have been used in the care of respiratory patients, including telemonitoring, teleconsultations, tele-education, and telehealth-pulmonary rehabilitation (PR). Telehealth technology provides an opportunity to assist in the management of chronic respiratory diseases and improve access to PR programs. While there is inconclusive evidence as to the effectiveness of telemonitoring to reduce healthcare utilization and detection of exacerbations, teleconsultations have been shown to be an effective means to assess patients’ disease prior to the initiation of PR, and telehealth PR has been shown to be as effective as institution-based PR at improving functional exercise capacity and health-related quality of life. To improve PR access across Canada and ensure a high standard of program quality, a team of clinicians and researchers has developed and begun to implement a national standardized PR program that can be delivered across different settings of practice, including remote satellite sites via telehealth PR. The program has adapted the “Living Well with COPD” self-management program and includes standardized reference guides and resources for patients and practitioners. A progressive and iterative process will evaluate the success of program implementation and outcomes. This initiative will address nationwide accessibility challenges and provide PR content as well as evaluations that are in accordance with clinical standards and established self-management practices.

Telemedicine as the New Outpatient Clinic Gone Digital: Position Paper From the Pandemic Health System REsilience PROGRAM (REPROGRAM) International Consortium (Part 2)

“…Pulmonary rehabilitation is essential for patients with chronic respiratory issues such as COPD and can be achieved through telehealth measures such as monitoring, consultation, and education (79). This is important in COPD, as potential exacerbations need to be monitored, and lower levels of rehabilitation access are associated with increased rates of hospitalization (79). Additionally, personal movement tracking devices involving accelerometers are helpful in tracking patient exercise, which is an essential area of pulmonary rehabilitation (80).…”

Advances in rehabilitation for chronic diseases: improving health outcomes and function

“…Interventions that use technology such as the internet and wearable devices have shown promise in supporting home based physical activity 109110111112113114. Most recently, tele-rehabilitation efforts used videoconferencing for home virtual supervision, but this still required personnel time and specialized exercise equipment 115116117118…”

Acceptance, adherence and dropout rates of individuals with COPD approached in telehealth interventions: a protocol for systematic review and meta-analysis

“…Telehealth refers to the use of electronic information and communication technologies to support distance healthcare, which allows healthcare professionals and long-distance patients to exchange information and enable access to healthcare services. Various terms are used throughout the medical industry to reference specific applications and use cases for telehealth—these are presented in table 1 5. For example, telehealth interventions with COPD could be used to deliver care and it can help to detect exacerbations at an early stage, minimising the potential for emergency admissions and facilitating self-management 5–8.…”