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在线平台为慢性呼吸系统疾病患者提供肺康复的可行性。

Feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease.

机构信息

Health Sciences, Brunel University London, London, UK

Gloucestershire Health and Care NHS Foundation Trust, Brockworth, UK.

出版信息

BMJ Open Respir Res. 2021 Mar;8(1). doi: 10.1136/bmjresp-2021-000880.


DOI:10.1136/bmjresp-2021-000880
PMID:33762360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7993314/
Abstract

INTRODUCTION: SARS-CoV-2 has restricted access to face-to-face delivery of pulmonary rehabilitation (PR). Evidence suggests that telehealth-PR is non-inferior to outpatient PR. However, it is unknown whether patients who have been referred to face-to-face programmes can feasibly complete an online-PR programme. METHODS: This service evaluation used a mixed-methods approach to investigate a rapid PR service remodelling using the University of Gloucestershire eLearn Moodle platform. Quantitative baseline demographic and PR outcome data were collected from online-PR participants, and semistructured interviews were completed with PR staff and participants. RESULTS: Twenty-five individuals were eligible from a PR waiting list. Thirteen declined participation and 14 completed PR. Significant pre-post online PR improvements were achieved in 1 min sit-to-stand (CI 2.1 to 9 (p=0.004)), Generalised Anxiety Disorder (CI -0.3 to -2.6 (p=0.023)), Primary Health Questionnaire-9 (CI -0.3 to -5.1 (p=0.029)), Chronic Respiratory Questionnaire dyspnoea (CI 0.5 to 1.3 (p=0.001)), fatigue (CI 0.7 to 2 (p=0.0004)), emotion (CI 0.7 to 1.7 (p=0.0002)), mastery (CI 0.4 to 1.3 (p=0.001)). Interviews indicated that patient PR inclusion was made possible with digital support and a PR introduction session improved participant engagement and safety. Incremental progression of exercise was perceived as more successful online compared with face-to-face PR. However, perceptions were that education sessions were less successful. Online-PR required significant staff time resource. DISCUSSION: Online-PR improves patient outcomes and is feasible and acceptable for individuals referred for face-to-face PR in the context of a requirement for social distancing. Face-to-face programmes can be adapted in a rapid fashion with both staff and participants perceiving benefit. Future pragmatic trials are now warranted comparing online-PR including remote assessments to centre-based PR with suitably matched outcomes, and patient and staff perceptions sought regarding barriers and facilitators of online delivery.

摘要

简介:SARS-CoV-2 限制了面对面的肺康复(PR)服务。有证据表明,远程医疗 PR 与门诊 PR 相比不劣效。然而,尚不清楚已经被转介到面对面项目的患者是否能够切实完成在线 PR 项目。

方法:本服务评估采用混合方法,调查了使用格鲁斯特大学 eLearn Moodle 平台快速重塑的 PR 服务。从在线 PR 参与者那里收集了定量基线人口统计学和 PR 结果数据,并对 PR 工作人员和参与者进行了半结构化访谈。

结果:从 PR 候补名单中选出了 25 名符合条件的个体。13 人拒绝参与,14 人完成了 PR。在线 PR 后显著改善:1 分钟坐立起身(CI 2.1 至 9,p=0.004)、广泛性焦虑障碍(CI-0.3 至-2.6,p=0.023)、初级健康问卷-9(CI-0.3 至-5.1,p=0.029)、慢性呼吸问卷呼吸困难(CI 0.5 至 1.3,p=0.001)、疲劳(CI 0.7 至 2,p=0.0004)、情绪(CI 0.7 至 1.7,p=0.0002)、掌控感(CI 0.4 至 1.3,p=0.001)。访谈表明,数字支持使得患者 PR 的纳入成为可能,并且 PR 介绍会提高参与者的参与度和安全性。与面对面 PR 相比,在线 PR 中运动的逐步增加被认为更成功。然而,有人认为教育课程不太成功。在线 PR 需要大量的员工时间资源。

讨论:在线 PR 可改善患者的预后,并且在需要保持社交距离的情况下,对于转介至面对面 PR 的个体而言,是可行且可接受的。可以快速调整面对面的项目,工作人员和参与者都能从中受益。现在需要进行未来的实用试验,将包括远程评估在内的在线 PR 与基于中心的 PR 进行比较,并获得患者和工作人员对在线交付的障碍和促进因素的看法。

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Healthcare (Basel). 2025-7-25

[3]
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Int J Chron Obstruct Pulmon Dis. 2025-3-5

[4]
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J Med Internet Res. 2024-12-12

[5]
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[6]
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[7]
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Digit Health. 2023-12-11

[8]
Developing a home-based pulmonary rehabilitation programme for patients with chronic respiratory diseases in Malaysia: A mixed-method feasibility study.

J Glob Health. 2023-10-27

[9]
Telemedicine in healthcare access during the covid-19 pandemic: a scoping review.

Rev Saude Publica. 2023

[10]
Listen to Me! - A Mixed-Methods Study of Thoughts and Attitudes Towards Participation in Pulmonary Telerehabilitation Among People with Severe and Very Severe COPD Who Declined Participation in Pulmonary Rehabilitation.

Patient Prefer Adherence. 2022-10-18

本文引用的文献

[1]
Telerehabilitation for chronic respiratory disease.

Cochrane Database Syst Rev. 2021-1-29

[2]
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[3]
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BMJ Open Respir Res. 2021-1

[4]
Moving singing for lung health online in response to COVID-19: experience from a randomised controlled trial.

BMJ Open Respir Res. 2020-11

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Respiratory patient experience of measures to reduce risk of COVID-19: findings from a descriptive cross-sectional UK wide survey.

BMJ Open. 2020-9-9

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Chron Respir Dis. 2020

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QJM. 2020-3-1

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Home versus outpatient pulmonary rehabilitation in COPD: a propensity-matched cohort study.

Thorax. 2019-7-5

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