Authors: (including presenting author): :
Yang SF(1)(2), Choi PY(1), Lau WLC(3), Tsui AYY(4), Ko WN(3), Kong ISY (4), Ho HW(1), Cheng RYF(1), Tang TT (1)(5), Yim CW(1), Ng PK(1), Chan D(3), Leung K(4), Kwan HY(1)
Affiliation: :
(1) Department of Respiratory Medicine, Kowloon Hospital (2) Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital (3) Occupational therapy Department, Kowloon Hospital (4) Physiotherapy Department, Kowloon Hospital (5) Department of Pulmonary and Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Introduction: :
The benefits of pulmonary rehabilitation (PR) for chronic respiratory disease (CRD) are well documented, but its success is often hindered by low recruitment rate and completion rate. Despite strong recommendation by international guidelines on referring CRD patients for PR, poor uptake, high default rate, and low PR completion rate (50-60% only), mostly due to transport and care-taker support issues, hindered its benefit. Tele-PR may solve the problem.
Objectives: :
To explore the benefits of tele-PR in patients with CRD and explore a suitable tele-PR model in Hong Kong.
Methodology: :
Our home-based supervised tele-PR was delivered in 14 sessions, once weekly for 3 months through video-conferencing by a multidisciplinary PR team, including respiratory doctor, nurse, physiotherapist (PT), and occupational therapist (OT). Each session lasted for 3 hours and contained all essential components in conventional PR: nurses provided patient education and empowerment, such as dyspnea management, smoking cessation counselling, coaching on inhalation therapy, infection prevention; PT offered exercise training programme, including sitting aerobic exercise, sputum clearance techniques, breathing techniques, theraband exercise and Tai-chi; OT educate patients on various techniques to live well with the disease, e.g. energy conservation, stress management, muscle relaxation, and Qi-gong practice. To assess patients’ outcomes, their lung function, exercise capacity (by 6-minute walking test, 6MWT), muscle strength (quadriceps and handgrip), functional performance (by monitored functional task evaluation, MFTE) and health-related quality of life (by chronic respiratory questionnaire, CRQ, and shortness of breath questionnaire, SOBQ) were compared before and after tele-PR. PR completion rate was defined by attending ≥50% of 14 sessions and post-PR assessment.
Result & Outcome: :
From 7/2021 to 12/2023, ten patients with CRD were recruited. During the recruitment process, major barrier to uptake was due to no internet access at home. After recruitment, only one patient failed to complete tele-PR due to underlying co-morbidities (completion rate: 90%). Others completed the program with 100% attendance rates. Participants demonstrated significant improvement in exercise capacity, muscle strength, functional performance, and health-related quality of life (P＜0.05). No adverse event was reported. Results suggested that the 3-month tele-PR model was feasible and effective in patients with CRD and achieved a higher attendance rates and completion rates compared with conventional PR. This pilot program also served as a guide for stratified mode of intervention to enrich efficacy of our PR program.
