AT ATS 2017

WASHINGTON (FRONTLINE MEDICAL NEWS) – An online pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD) was not inferior to an in-person program, according to study findings presented at an international conference of the American Thoracic Society, Tuesday.

In a walking test conducted after all patients completed a 7-week program, participants in the online program, on average, increased their 6MWT (6-minute walking test) score by 23.8 m (P = .098) from baseline; this amount of improvement is much greater than the noninferiority threshold for this study. COPD assessment, hospital anxiety, respiratory function, and modified medical research council dyspnea scores of patients who participated in the online program were also not inferior to the scores of patients who participated in the in-person program.

If found to be a viable option, online options for COPD patients could be useful for treatment in those who would otherwise not have access to in-person rehabilitation sessions, said Tom Wilkinson, MD, PhD, of the University of Southhampton (England), in his presentation.

“The challenges for patients with COPD are quite real; there are factors which are limiting the access of treatments … in the way of geography of where our patients live,” said Dr. Wilkinson. “[Also] some patients may be housebound or have social anxiety but would benefit from using programs more regularly.”

The study’s 90 participants were assigned to participate either in an online program designed as an in-home guide for pulmonary rehabilitation or in pulmonary rehabilitation sessions at a local facility, after a baseline 6-minute walking test, according to Dr. Wilkinson.

The average age of patients participating in the face-to-face program was 71 years, while the average age for the online group was 69 years. Both groups were predominantly male and former smokers.

Investigators designed the online program to mimic face-to-face sessions by integrating advice on exercises, and information about a patient’s condition, into the program. While the online program included five sessions per week of either exercise or education, the program for patients in the control group involved two facility sessions per week.

Dr. Wilkinson said the online form of rehabilitation used in this study would not only benefit patients, but would help hospitals financially.

An online application could be a helpful supplement for facilities that do not have the resources to hire additional workers or do not have the proper facility to conduct these sessions, he added.

Attendees expressed concern that the learning curve of an online platform could make participating in the program difficult for COPD patients.

Dr. Wilkinson said he and his team had taken that potential learning curve into account when designing the program, by including digital literacy programs and a service hotline.

This study was funded by a grant awarded through the U.K. small business research initiative. The investigators reported no relevant financial disclosures.

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