From face-to-face to telerehabilitation: patients prefer a mixed model on a pandemic-free future

Abstract

With worldwide coronavirus disease 2019, pulmonary rehabilitation face-to-face interventions (FFI) were cancelled and telerehabilitation (TR) emerged as a strategic pandemic response.

Aims and objectives: To evaluate impact on patient’s self-efficacy and routines of breathing exercises and physical activity, reported experience from FFI to TR, and perceived health status.

Methods: Qualitative observational prospective study with 2 telephone surveys (March and August 2020) to pulmonary rehabilitation outpatients. Application of the Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) and assessment of breathing exercises and physical activity routines. Follow-up also assessed: TR communication features; satisfaction levels; future program preference; perceived health status evolution and impact of cancelled FFI.

Results: Participants (n=100) were 51% male, with mean age of 64.5 ± 13.1 years. Diagnosis included: chronic obstructive pulmonary disease (32%), bronchiectasis (21%), interstitial lung disease (16%), lung cancer (14%), asthma (9%) and others (8%). Self-efficacy remained stable with initial PRAISE mean of 48.3 ± 6.9 vs 47.8 ± 7.8 follow-up. Breathing exercises were suspended in 66% of patients, and 47% discontinued physical activity. TR was provided to 48% of patients, with only 27.1% by video call. TR patients perceived higher negative impact of cancelled FFI on their health status, but also higher satisfaction levels on receiving TR, with 40% preferring a mixed program on a pandemic-free future.

Conclusions: TR is a strategic key innovative shift to current and future successful pulmonary rehabilitation delivery and accessibility.