Development and Feasibility of a Home Pulmonary Rehabilitation Program With Health Coaching

Respir Care. 2018 Feb;63(2):131-140. doi: 10.4187/respcare.05690. Epub 2017 Oct 24.

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.).

Keywords: COPD; health coaching; home-based pulmonary rehabilitation; motivational interviewing; pulmonary rehabilitation; quality of life; self-management.

Publication types

  • Clinical Trial
  • Editorial

MeSH terms

  • Aged
  • Exercise Therapy / methods
  • Feasibility Studies
  • Female
  • Home Care Services*
  • Humans
  • Male
  • Mentoring / methods*
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Patient Compliance
  • Patient Satisfaction
  • Pilot Projects
  • Program Evaluation
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Research Design
  • Telemetry / methods
  • Telerehabilitation / methods*

Associated data

  • ClinicalTrials.gov/NCT02999685