title: Using Telehealth technology to deliver pulmonary rehabilitation in chronic obstructive pulmonary disease patients.
abstract: BACKGROUND
  Pulmonary rehabilitation (PR) is an effective therapeutic strategy to improve health outcomes in patients with chronic obstructive pulmonary disease (COPD); however, there is insufficient PR capacity to service all COPD patients, thus necessitating creative solutions to increase the availability of PR.
  
  
  OBJECTIVE
  To examine the efficacy of PR delivered via Telehealth (Telehealth-PR) compared with PR delivered in person through a standard outpatient hospital-based program (Standard-PR).
  
  
  METHODS
  One hundred forty-seven COPD patients participated in an eight-week rural PR program delivered via Telehealth-PR. Data were compared with a parallel group of 262 COPD patients who attended Standard-PR. Education sessions were administered two days per week via Telehealth, and patients exercised at their satellite centre under direct supervision. Standard-PR patients viewed the same education sessions in person and exercised at the main PR site. The primary outcome measure was change in quality of life as evaluated by the St George's Respiratory Questionnaire (SGRQ). A noninferiority analysis was performed using both intention-to-treat and per-protocol approaches.
  
  
  RESULTS
  Both Telehealth-PR and Standard-PR resulted in clinically and statistically significant improvements in SGRQ scores (4.5 ± 0.8% versus 4.1 ± 0.6%; P<0.05 versus baseline for both groups), and the improvement in SGRQ was not different between the two programs. Similarly, exercise capacity, as assessed by 12 min walk test, improved equally in both Telehealth-PR and Standard-PR programs (81±10 m versus 82 ± 10 m; P<0.05 versus baseline for both groups).
  
  
  CONCLUSIONS
  Telehealth-PR was an effective tool for increasing COPD PR services, and demonstrated improvements in quality of life and exercise capacity comparable with Standard-PR.
authors: Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. michael.stickland@ulaberta.ca
authors: Michael
authors: M
authors: Stickland
authors: Tina
authors: T
authors: Jourdain
authors: Erie Y L
authors: EY
authors: Wong
authors: Wendy M
authors: WM
authors: Rodgers
authors: Nicholas G
authors: NG
authors: Jendzjowsky
authors: G Fred
authors: GF
authors: Macdonald
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000592:standards; D017079:Exercise Tolerance; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D058996:Quality Improvement / Q000458:organization & administration; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods / Q000592:standards; D016896:Treatment Outcome