Patient Preference and Adherence (Oct 2022)
Listen to Me! – A Mixed-Methods Study of Thoughts and Attitudes Towards Participation in Pulmonary Telerehabilitation Among People with Severe and Very Severe COPD Who Declined Participation in Pulmonary Rehabilitation
Abstract
Kira Marie Skibdal,1 Christina Emme,2 Henrik Hansen3 1Department of Physical and Occupational Therapy, University Hospital Amager-Hvidovre Hospital, Hvidovre, Denmark; 2Department of Quality and Education, University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark; 3Respiratory Research Unit and Department of Respiratory Medicine, University Hospital Amager Hvidovre Hospital, Hvidovre, DenmarkCorrespondence: Henrik Hansen, Email [email protected]: Pulmonary rehabilitation (PR) is a key standard treatment for people with chronic obstructive pulmonary disease (COPD) with documented effect on symptom relief, improved physical function, and quality of life. However, referral, uptake and adherence rates remain low. Pulmonary telerehabilitation (PTR) is a safe and effective alternative to conventional PR. This study explores associations, thoughts and attitudes towards PTR in patients with COPD who decline referral to outpatient hospital-based routine PR.Methods: A mixed-methods study with integration of survey data (n=84) and semi-structured interviews (n=9).Results: We found a significant association between belief of effect of PTR and willingness to participate. Increasing age was significantly associated with reduced odds of daily use of central processing unit (CPU) or tablet. One-third of the participants were undecided about potential participation in PTR. Qualitative findings highlight that participants perceived participating in PTR as more convenient and had preferences for individualized, supervised, and monitored rehabilitation.Conclusion: Those willing to participate in a PTR program believed in the benefits, were comfortable with technological devices, had preferences for exercising at home, and saw opportunities in the social setting. Future PTR programs should include monitoring, preferably managed by a familiar health care professional (HCP).Keywords: COPD, pulmonary rehabilitation, pulmonary telerehabilitation, Theoretical Domains Framework
