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      Long-term integrated telerehabilitation of COPD Patients: a multicentre randomised controlled trial (iTrain).

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          Abstract

          Pulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic obstructive pulmonary disease (COPD). However, available resources are often limited, and many patients bear with poor availability of programmes. Sustaining PR benefits and regular exercise over the long term is difficult without any exercise maintenance strategy. In contrast to traditional centre-based PR programmes, telerehabilitation may promote more effective integration of exercise routines into daily life over the longer term and broaden its applicability and availability. A few studies showed promising results for telerehabilitation, but mostly with short-term interventions. The aim of this study is to compare long-term telerehabilitation with unsupervised exercise training at home and with standard care.

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          Pulmonary rehabilitation for chronic obstructive pulmonary disease.

          Bernard McCarthy, Dympna Casey, Declan Devane … (2015)
          Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
          Article 0 comments Cited 603 times – based on 0 reviews     Review now
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            Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention.

            Jean Bourbeau, Marcel Julien, François Maltais … (2003)
            Self-management interventions improve various outcomes for many chronic diseases. The definite place of self-management in the care of chronic obstructive pulmonary disease (COPD) has not been established. We evaluated the effect of a continuum of self-management, specific to COPD, on the use of hospital services and health status among patients with moderate to severe disease. A multicenter, randomized clinical trial was carried out in 7 hospitals from February 1998 to July 1999. All patients had advanced COPD with at least 1 hospitalization for exacerbation in the previous year. Patients were assigned to a self-management program or to usual care. The intervention consisted of a comprehensive patient education program administered through weekly visits by trained health professionals over a 2-month period with monthly telephone follow-up. Over 12 months, data were collected regarding the primary outcome and number of hospitalizations; secondary outcomes included emergency visits and patient health status. Hospital admissions for exacerbation of COPD were reduced by 39.8% in the intervention group compared with the usual care group (P =.01), and admissions for other health problems were reduced by 57.1% (P =.01). Emergency department visits were reduced by 41.0% (P =.02) and unscheduled physician visits by 58.9% (P =.003). Greater improvements in the impact subscale and total quality-of-life scores were observed in the intervention group at 4 months, although some of the benefits were maintained only for the impact score at 12 months. A continuum of self-management for COPD patients provided by a trained health professional can significantly reduce the utilization of health care services and improve health status. This approach of care can be implemented within normal practice.
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              The economic burden of COPD.

              Sean D Sullivan, Scott Ramsey, Todd Lee (2000)
              COPD is one of the leading causes of morbidity and mortality worldwide and imparts a substantial economic burden on individuals and society. Despite the intense interest in COPD among clinicians and researchers, there is a paucity of data on health-care utilization, costs, and social burden in this population. The total economic costs of COPD morbidity and mortality in the United States were estimated at $23.9 billion in 1993. Direct treatments for COPD-related illness accounted for $14.7 billion, and the remaining $9.2 billion were indirect morbidity and premature mortality estimated as lost future earnings. Similar data from another US study suggest that 10% of persons with COPD account for > 70% of all medical care costs. International studies of trends in COPD-related hospitalization indicate that although the average length of stay has decreased since 1972, admissions per 1,000 persons per year for COPD have increased in all age groups > 45 years of age. These trends reflect population aging, smoking patterns, institutional factors, and treatment practices.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): BMC Pulm Med
                Title: BMC pulmonary medicine
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1471-2466
                ISSN (Print): 1471-2466
                Publication date (Electronic): August 22 2016
                Volume: 16
                Issue: 1
                Affiliations
                [1 ] Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway. paolo.zanaboni@telemed.no.
                [2 ] Department of Health Science and Technology, Laboratory of Assistive Technologies - Telehealth & Telerehabilitation, SMI, Aalborg University, Aalborg, Denmark.
                [3 ] Heart and Lung Clinic, University Hospital of North Norway, Tromsø, Norway.
                [4 ] Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.
                [5 ] Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
                [6 ] La Trobe University, Melbourne, Australia.
                [7 ] Alfred Health, Melbourne, Australia.
                [8 ] Institute for Breathing and Sleep, Melbourne, Australia.
                Article
                Publisher Item ID: 10.1186/s12890-016-0288-z
                DOI: 10.1186/s12890-016-0288-z
                PMC ID: 4994273
                PubMed ID: 27549782
                SO-VID: e3bf9c0c-775a-49de-b432-1cd4e4eb3087
                History

                Keywords: COPD,Exercise,Home monitoring,Pulmonary rehabilitation,Telemedicine,Telerehabilitation
                Data availability:
                Keywords: COPD, Exercise, Home monitoring, Pulmonary rehabilitation, Telemedicine, Telerehabilitation

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