BACKGROUND:Pulmonary rehabilitation (PR) is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease (COPD); however, there is insufficient PR capacity to service all COPD patients, thus necessitating creative solutions to increase the availability of PR. OBJECTIVE: To examine the efficacy of PR delivered via Telehealth (Telehealth-PR) compared with PR delivered in person through a standard outpatient hospital-based program (Standard-PR). METHODS:One hundred forty-seven COPD patients participated in an eight-week ruralPR program delivered via Telehealth-PR. Data were compared with a parallel group of 262 COPD patients who attended Standard-PR. Education sessions were administered two days per week via Telehealth, and patients exercised at their satellite centre under direct supervision. Standard-PR patients viewed the same education sessions in person and exercised at the main PR site. The primary outcome measure was change in quality of life as evaluated by the St George's Respiratory Questionnaire (SGRQ). A noninferiority analysis was performed using both intention-to-treat and per-protocol approaches. RESULTS: Both Telehealth-PR and Standard-PR resulted in clinically and statistically significant improvements in SGRQ scores (4.5 ± 0.8% versus 4.1 ± 0.6%; P<0.05 versus baseline for both groups), and the improvement in SGRQ was not different between the two programs. Similarly, exercise capacity, as assessed by 12 min walk test, improved equally in both Telehealth-PR and Standard-PR programs (81±10 m versus 82 ± 10 m; P<0.05 versus baseline for both groups). CONCLUSION: Telehealth-PR was an effective tool for increasing COPD PR services, and demonstrated improvements in quality of life and exercise capacity comparable with Standard-PR.
RCT Entities:
BACKGROUND: Pulmonary rehabilitation (PR) is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease (COPD); however, there is insufficient PR capacity to service all COPDpatients, thus necessitating creative solutions to increase the availability of PR. OBJECTIVE: To examine the efficacy of PR delivered via Telehealth (Telehealth-PR) compared with PR delivered in person through a standard outpatient hospital-based program (Standard-PR). METHODS: One hundred forty-seven COPDpatients participated in an eight-week rural PR program delivered via Telehealth-PR. Data were compared with a parallel group of 262 COPDpatients who attended Standard-PR. Education sessions were administered two days per week via Telehealth, and patients exercised at their satellite centre under direct supervision. Standard-PR patients viewed the same education sessions in person and exercised at the main PR site. The primary outcome measure was change in quality of life as evaluated by the St George's Respiratory Questionnaire (SGRQ). A noninferiority analysis was performed using both intention-to-treat and per-protocol approaches. RESULTS: Both Telehealth-PR and Standard-PR resulted in clinically and statistically significant improvements in SGRQ scores (4.5 ± 0.8% versus 4.1 ± 0.6%; P<0.05 versus baseline for both groups), and the improvement in SGRQ was not different between the two programs. Similarly, exercise capacity, as assessed by 12 min walk test, improved equally in both Telehealth-PR and Standard-PR programs (81±10 m versus 82 ± 10 m; P<0.05 versus baseline for both groups). CONCLUSION: Telehealth-PR was an effective tool for increasing COPD PR services, and demonstrated improvements in quality of life and exercise capacity comparable with Standard-PR.
Authors: François Maltais; Jean Bourbeau; Stan Shapiro; Yves Lacasse; Hélène Perrault; Marc Baltzan; Paul Hernandez; Michel Rouleau; Marcel Julien; Simon Parenteau; Bruno Paradis; Robert D Levy; Pat Camp; Richard Lecours; Richard Audet; Brian Hutton; John R Penrod; Danielle Picard; Sarah Bernard Journal: Ann Intern Med Date: 2008-12-16 Impact factor: 25.391
Authors: Denis E O'Donnell; Shaw Aaron; Jean Bourbeau; Paul Hernandez; Darcy D Marciniuk; Meyer Balter; Gordon Ford; Andre Gervais; Rogers Goldstein; Rick Hodder; Alan Kaplan; Sean Keenan; Yves Lacasse; Francois Maltais; Jeremy Road; Graeme Rocker; Don Sin; Tasmin Sinuff; Nha Voduc Journal: Can Respir J Date: 2007-09 Impact factor: 2.409
Authors: María Rosa Güell; Pilar de Lucas; Juan Bautista Gáldiz; Teodoro Montemayor; José Miguel Rodríguez González-Moro; Amaia Gorostiza; Francisco Ortega; José M Bellón; Gordon Guyatt Journal: Arch Bronconeumol Date: 2008-10 Impact factor: 4.872
Authors: Pat G Camp; Paul Hernandez; Jean Bourbeau; Ashley Kirkham; Richard Debigare; Michael K Stickland; Donna Goodridge; Darcy D Marciniuk; Jeremy D Road; Mohit Bhutani; Gail Dechman Journal: Can Respir J Date: 2015-04-07 Impact factor: 2.409
Authors: Rashid L Bashshur; Gary W Shannon; Brian R Smith; Dale C Alverson; Nina Antoniotti; William G Barsan; Noura Bashshur; Edward M Brown; Molly J Coye; Charles R Doarn; Stewart Ferguson; Jim Grigsby; Elizabeth A Krupinski; Joseph C Kvedar; Jonathan Linkous; Ronald C Merrell; Thomas Nesbitt; Ronald Poropatich; Karen S Rheuban; Jay H Sanders; Andrew R Watson; Ronald S Weinstein; Peter Yellowlees Journal: Telemed J E Health Date: 2014-06-26 Impact factor: 3.536
Authors: Narelle S Cox; Simone Dal Corso; Henrik Hansen; Christine F McDonald; Catherine J Hill; Paolo Zanaboni; Jennifer A Alison; Paul O'Halloran; Heather Macdonald; Anne E Holland Journal: Cochrane Database Syst Rev Date: 2021-01-29