Introduction Face-to-face pulmonary rehabilitation (PR) programmes were largely stopped in the UK in March 2020 due to concerns about the transmission of the COVID-19 virus. However there was still a need to support patients with COPD to self-manage their condition. Indeed social isolation and deconditioning were cause for concern in this population. The aim of this work was to gauge the appetite for 3 different models of remote self-management support and to explore the uptake, completion and clinical outcomes of these 3 options.
Methods Between March 2020- March 2021, 3 remote options for self-management were offered: telephone support (TP: biweekly for 6weeks with home exercise and education booklet), SPACE for COPD Manual (SM: with phone calls at week 2 and week 4), SPACE for COPD Website (SW: email prompts and contact health professional function). All patients had a subjective assessment (including risk assessment) completed over the phone. All programmes included self-management education and a home exercise programme (walking, strength exercises using free weights). Outcomes assessed were: uptake and completion rates, COPD Assessment Test (CAT), Chronic Respiratory Questionnaire (CRQ)- all domains.
Results N=287 patients chose a remote option and were included in the analysis. All patients had a spirometry diagnosis of COPD. Mean (SD) age 66.4 (10.2) years. 67% chose TP, 22% chose SM, 11% chose SW. Completion rates were: 56% TP, 52% SM and 30% SW (significant p<0.05 between TP and SW). Table 1 displays the change in outcomes for the 3 choices. There were within group improvements for all outcomes, all meeting the clinically relevant thresholds in this population (except for the CRQ-fatigue and emotion domains in the TP group). There were statistically significant changes in a number of outcomes (*) but no between group differences.
Conclusion Most patients chose bi-weekly telephone support, TP and SM had the highest completion rate. All options were equally effective in terms of clinical outcomes. Despite being clinically effective, more work is needed to promote completion in digitally delivered self-management programmes.
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