Virtual pulmonary rehab effective for high-need COPD patients

Virtual pulmonary rehabilitation is safe and effective for chronic obstructive pulmonary disease patients who require supplemental oxygen, expanding access to rehab programs for a broader range of patients, a recent research report shows.

The report, published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, examined whether virtual pulmonary rehabilitation is safe and effective for COPD patients who require supplemental oxygen compared to those who do not.

COPD, a chronic lung disease, is progressive and gets worse over time. Pulmonary rehabilitation, or PR, is one way to manage COPD. It offers education and exercises to mitigate the symptoms of COPD, like shortness of breath. Virtual PR programs deliver the education and exercises via telehealth.

For the study, researchers conducted a retrospective review of COPD patients who completed an eight-week virtual PR program from October 2022 to November 2023. All patients had baseline pulmonary function testing and a COPD diagnosis at enrollment. Following intake, patients received an individualized exercise plan. They attended classes led by a respiratory therapist in small groups via a telehealth platform, with real-time remote patient monitoring of heart rate and oxygen levels using a pulse oximeter wristwatch.

The researchers included 167 patients in the study, of which 107 required oxygen and 60 did not. The median program attendance was 88%, with no significant difference between the oxygen and non-oxygen groups. A vast majority of patients (99%) did not experience any adverse effects.

Most patients (83%) completed the program, with no significant differences observed based on oxygen use. Both groups also showed comparable improvements in clinical outcomes. 

Thus, researchers concluded that oxygen-dependent patients can safely participate in virtual PR programs and experience benefits similar to those of patients who do not need oxygen. Further, virtual PR can help increase access to these services and personalized care.

"Our findings demonstrate the need to increase use of virtual pulmonary rehabilitation programs to help improve the quality of life for people with COPD," said co-senior author of the report, Russell Buhr, M.D., Ph.D., a pulmonologist at the University of California, Los Angeles, in a press release. "By evaluating each patient’s situation and incorporating virtually accessible programs, we can offer more individualized care for patients."

This study adds to growing evidence that virtual tools benefit COPD management.

A study published in 2023 showed that remote cardiorespiratory monitoring helped reduce all-cause and cardiopulmonary hospitalization rates among COPD patients. The researchers conducted a retrospective analysis of unplanned hospitalizations among 126 COPD patients participating in an RPM program for at least a year.

They analyzed the EMR data of patients one year before and after the program. They found that the RPM intervention decreased the frequency of all-cause hospitalizations in the cohort by 65% and cardiopulmonary hospitalizations decreased by 63.6%. Additionally, emergency room visits decreased by 44.3%.

However, it is important to note that research into other types of virtual rehab indicates the need for age-specific virtual care strategies. For example, a study published earlier this year revealed that using virtual care tools to deliver rehab services at home to older adults with ischemic heart disease did not improve functional outcomes.

Not only was there no improvement in functional metrics, like the six-minute walk distance test, but there was also a higher rate of hospitalization among patients in the virtual program compared to patients in the control group.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.