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S98 Effectiveness of home maintenance tele-rehabilitation on COPD exacerbations
  1. G Kaltsakas1,
  2. AI Papaioannou2,
  3. M Vasilopoulou3,
  4. S Spetsioti3,
  5. SA Gennimata1,
  6. AF Palamidas1,
  7. N Chynkiamis3,
  8. E Kortianou1,
  9. T Vasilogiannakopoulou3,
  10. I Vogiatzis3,
  11. NG Koulouris1
  1. 1Respiratory Function Lab, 1st Respiratory Medicine Department, “Sotiria” Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
  2. 2Filoktitis, Center for Recovery & Rehabilitation, Koropi, Athens, Greece
  3. 3Faculty of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Athens, Greece

Abstract

Acute exacerbations are cardinal events in the natural history of chronic obstructive pulmonary disease (COPD) and are associated with increased morbidity and mortality. Tele-monitoring interventions are a relatively new field in COPD research and management. Furthermore, the effect of home tele-rehabilitation on COPD exacerbation has not been thoroughly studied. Therefore, we set out to investigate whether a home tele-rehabilitation program would be as beneficial as an outpatient maintenance rehabilitation program, in the context of COPD exacerbations, following completion of a 3-month course of supervised pulmonary rehabilitation.

We studied 137 Caucasian, ambulatory COPD patients. Forty seven patients were assigned to home maintenance tele-rehabilitation (FEV1,%pred = 50 ± 22, mean±SD). Fifty patients were assigned to twice weekly hospital-based maintenance rehabilitation (FEV1,%pred = 52 ± 17). Forty COPD patients (FEV1, %pred = 52 ± 21), were not assigned to any rehabilitation program and served as controls. Tele-rehabilitation included home exercise reconditioning, self-management techniques, dietary, and psychological advice. Patients were provided with tablets and wireless devices to record and transmit data, related to symptoms, lung function, and vital signs, to a tele-health platform. Patients were followed up for 12 months.

At baseline there were no significant differences amongst the tele-rehabilitation (3.3 ± 3.1), hospital-based rehabilitation (3.4 ± 1.9), or control (3.3 ± 1.6), groups in terms of COPD exacerbations. After 12 months, COPD exacerbations in the group of home tele-rehabilitation were significantly reduced to 1.7 ± 1.7. In the group of hospital-based rehabilitation COPD exacerbations were also significantly reduced to 1.8 ± 1.4. In contrast, in the control group COPD exacerbations remained unchanged (3.5 ± 1.7). There were significant difference amongst the two rehabilitation groups (tele-rehabilitation and hospital-based) and the control group in terms of COPD exacerbations (p < 0.001).

In conclusion, ongoing home tele-rehabilitation with the use of tele-monitoring could significantly reduce COPD exacerbations and seems to be as beneficial as an outpatient hospital-based maintenance rehabilitation program in the context of COPD exacerbations. Thus, tele-rehabilitation may constitute a satisfactory alternative rehabilitative strategy to diminish health care costs.

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