Abstract
Rationale: Benefits of pulmonary rehabilitation (PR) are well established, but accessibility of patients, adherence, long-term sustainability of effects, impact on life style and sustainability of the programs are unsolved issues.
Hypothesis: Wellness programs based on Integrated Care Services supported by Information and Communication Technologies (ICS-ICT) can overcome current constraints of PR.
Methods: 421 patients were assessed in the 3 sites of the NEXES project, but only 104 out of 207 COPD patients studied in a quasi-experimental design in Barcelona completed a follow-up of 22±12m. We report on three matched groups: Usual Care (UC, n=27); 8-w endurance Training followed by Usual Care (T+UC, n=38); or followed by ICS-ICT (n=26). Six-min walking test (6MWT), endurance time (ET) and Saint George's Respiratory Questionnaire (SGRQ) were assessed at baseline, after training and at the end of the study, together with daily physical activity with Baecke's Modified Questionnaire (BMQ).
Results: PR effects in 6MWT were similar between T+UC and ICS-ICT (p=ns), but whereas ICS-ICT showed sustainability of PR effects (Δ6MWT -1±49m and ΔET 123±533sec; p=ns each), both (T+UC and UC) fell during the follow-up, Δ6MWT -40±46 and -44±50 respectively (p<0.01). Moreover, ICS-ICT enhanced SGRQ (p=0.02) and daily physical activity (p=0.03), not seen in controls.
Conclusions: ICT-supported enhanced wellness programs show potential to overcome limitations of classical PR.
Supported by NEXES (EU Grant CIP-ICT-PSP-2007-225025) and PITES (FIS-PI09/90634).
- © 2013 ERS
