Abstract
BACKGROUND: Pulmonary rehabilitation (PR) is an effective intervention for COPD. However, traditional center-based PR programs suffer from low uptake. Home-based PR is a viable solution, but few studies have shown the effectiveness of remote PR, as there is a scarcity of systems that can be easily adopted in clinical practice. The aim of this report is to communicate the development and feasibility of a home PR program that includes commercially available technology that allows the PR health coach to follow the patient through his or her PR process and to present the design of a prospective clinical trial.
METHODS: We developed a home PR system that includes a computer tablet, an activity monitor, and an oximeter connected to a cloud server. The home PR consists of 12 min of walking and 6 full-body exercises, to be completed 6 d/week, plus weekly telephone calls with the PR health coach. Two pilot studies were conducted in subjects with moderate-to-severe COPD. The first aimed to fine-tune the system development (N = 3), and the second tested the program feasibility of the 8-week program (N = 12).
RESULTS: In pilot study 1, PR monitoring data from the subjects' home PR sessions were transmitted to the health coach application successfully. On a 10-point scale, participants rated the system as helpful (median = 8, interquartile range 8–9) and simple to use (median = 10, interquartile range 9–10). In pilot study 2, adherence ± SD for prescribed use was 87 ± 0.24%. Overall, participants gave the home PR system a rating of 6.2 ± 0.94 on a 7-point scale.
CONCLUSIONS: A home PR program was developed that integrated health coaching and a home PR system that facilitated remote monitoring. Pilot testing indicated that the program is well-developed and feasible in a population of individuals with COPD. (ClinicalTrials.gov registration NCT02999685.)
- COPD
- pulmonary rehabilitation
- health coaching
- quality of life
- motivational interviewing
- self-management
- home-based pulmonary rehabilitation
Footnotes
- Correspondence: Roberto Benzo MD MSc, Mindful Breathing Laboratory, Division of Pulmonary and Critical Care, Mayo Clinic, 200 First Street SW, Gonda 18-440, Rochester, MN 55902. E-mail: benzo.roberto{at}mayo.edu.
Dr Benzo, Ms Hoult, Ms Seifert, and Dr Kramer are supported by National Institutes of Health Grant SBIRHL 114162-2 (to Ms Seifert [PI] and Dr Benzo [clinical trial PI]). Ms Seifert has disclosed a relationship with NovuHealth. The other authors have disclosed no conflicts of interest.
Supplementary material related to this paper is available at http://www.rcjournal.com.
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