PMID- 31040656
OWN - NLM
STAT- MEDLINE
DCOM- 20191219
LR  - 20200309
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 14
DP  - 2019
TI  - Safety, feasibility, and effectiveness of virtual pulmonary rehabilitation in the 
      real world.
PG  - 775-780
LID - 10.2147/COPD.S193827 [doi]
AB  - PURPOSE: To assess the feasibility, safety, and effectiveness of a VIrtual 
      PulmonAry Rehabilitation (VIPAR) program in a real-world setting. PATIENTS AND 
      METHODS: Twenty-one patients with stable chronic lung disease at a spoke site 
      received (VIPAR) through live video conferencing with a hub where 24 patients 
      were receiving 14 sessions of standard, outpatient, multi-disciplinary pulmonary 
      rehabilitation (PR) in a hospital. We studied three such consecutive PR programs 
      with 6-10 patients at each site. The hub had a senior physiotherapist, 
      occupational therapist, exercise assistant, and guest lecturer, and the spoke 
      usually had only an exercise instructor and nurse present. Uptake, adverse events 
      (AEs), and early clinical changes were compared within and between groups. Travel 
      distances were estimated using zip codes. RESULTS: Mean attendance was 11.0 
      sessions in the hub and 10.5 sessions in the spoke (P=0.65). There was a single 
      (mild) AE (hypoglycemia) in all three hub programs and no AEs in the three spoke 
      programs. Mean COPD Assessment Test scores improved from 25.3 to 21.5 in the hub 
      (P<0.001, 95% CI 2.43-5.17) and from 23.4 to 18.8 (P<0.001, 2.23-7.02) in the 
      spoke group, with no difference between the groups (P=0.51, -3.35-1.70). Mean 
      incremental shuttle walk test scores improved from 142 to 208 m (P<0.001, 75-199) 
      in the hub and from 179 to 316 minutes in the spoke (P<0.001, 39.3-92.4), with a 
      greater improvement in the spoke (P=0.025, 9.31-133). Twenty-one patients saved a 
      total of 8,609.8 miles over the three programs by having the PR in their local 
      spoke, rather than traveling to the usual nearest (hospital) hub. CONCLUSION: 
      Video-conferencing, which links a local site to a standard PR program is 
      feasible, safe, and demonstrates at least equivalent short-term clinical gains. 
      Throughput can be increased, with less staffing ratios and significantly less 
      traveling.
FAU - Knox, Liam
AU  - Knox L
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Dunning, Michelle
AU  - Dunning M
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Davies, Carol-Anne
AU  - Davies CA
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Mills-Bennet, Rebekah
AU  - Mills-Bennet R
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Sion, Trystan Wyn
AU  - Sion TW
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Phipps, Kerrie
AU  - Phipps K
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Stevenson, Vicky
AU  - Stevenson V
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Hurlin, Claire
AU  - Hurlin C
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
FAU - Lewis, Keir
AU  - Lewis K
AD  - Hywel Dda University Health Board, UK, liam.knox@wales.nhs.uk.
AD  - School of Medicine, University of Swansea, Swansea, UK.
LA  - eng
PT  - Journal Article
DEP - 20190408
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Exercise Tolerance
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Lung/*physiopathology
MH  - Lung Diseases/diagnosis/physiopathology/*rehabilitation
MH  - Male
MH  - Middle Aged
MH  - Patient Care Team
MH  - Program Evaluation
MH  - Quality of Life
MH  - Recovery of Function
MH  - *Remote Consultation
MH  - *Telerehabilitation
MH  - Time Factors
MH  - Treatment Outcome
MH  - Walk Test
PMC - PMC6459142
OTO - NOTNLM
OT  - prudent healthcare
OT  - pulmonary rehabilitation
OT  - telemedicine
OT  - video-linking
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2019/05/02 06:00
MHDA- 2019/12/20 06:00
PMCR- 2019/04/08
CRDT- 2019/05/02 06:00
PHST- 2019/05/02 06:00 [entrez]
PHST- 2019/05/02 06:00 [pubmed]
PHST- 2019/12/20 06:00 [medline]
PHST- 2019/04/08 00:00 [pmc-release]
AID - copd-14-775 [pii]
AID - 10.2147/COPD.S193827 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2019 Apr 8;14:775-780. doi: 
      10.2147/COPD.S193827. eCollection 2019.