Home-based lung rehab a feasible option

Pulmonary rehabilitation in the home is a feasible option for COPD patients who cannot access centre-based programs, the conference has heard.

Physiotherapist Dr Anne Holland from La Trobe University and colleagues found that COPD patients with stable disease taking part in a home-based pulmonary rehabilitation program had similar quality of life and exercise capacity outcomes as those taking part in a standard outpatient program of care.

However many more patients were able to complete the home-based program, the researchers found.

Overall, 50% of patients completed the outpatient program – defined as having attended 70% of the sessions – compared to 91% of the home-based participants.

“This suggests that home-based rehab could be a great way to improve access and uptake of pulmonary rehabilitation programs, so that we can deliver this important treatment to more people who need it,” Dr Holland told the limbic.

Like a lot of previous studies the researchers found that the benefits seen in both groups were not sustained after 12 months.

“We need new ways to help people maintain the benefits they have achieved from pulmonary rehabilitation,” Dr Holland said.

In the question time following the presentation a member of the audience asked Dr Holland how she knew patients in the home-based program were doing the exercises given that they were unsupervised.

“The answer is that we don’t really know – but that is the nature of disease self-management,” she told the limbic.

“The fact that we had improvements in exercise capacity that were equivalent to those in the traditional centre-based group suggests that our program of structured telephone calls, using a motivational interviewing approach, was successful in assisting our participants to find their own motivation to engage in their exercise program,” she said.

Dr Holland presented her findings at a COPD oral session on Tuesday morning. In her study 166 patients with stable COPD with an average FEV1 50 % predicted were randomised to receive eight weeks of standard outpatient pulmonary rehab or a home-based model involving one home visit followed up by weekly telephone calls using a motivational interviewing approach. Both models of care had a similar cost.

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