Counterpoint: In-Home Pulmonary Rehabilitation Is an Attractive Alternative

Respir Care. 2024 May 28;69(6):763-771. doi: 10.4187/respcare.11957.

Abstract

Center-based pulmonary rehabilitation is positioned as the accepted standard for pulmonary rehabilitation. There, however, are several barriers to its utilization, and usage rates remain as low as 4%, despite decades of trying to improve access. The question then arises as to who is really benefiting from center-based pulmonary rehabilitation as this therapy is barely available to eligible patients. Alternative modes of delivery of pulmonary rehabilitation have been tested. Meta-analyses indicate that these alternate modes are associated with clinical improvements comparable with center-based pulmonary rehabilitation in several outcomes that are important for patients, including the 6-min walk distance, dyspnea, and quality of life. These modes are also associated with better adherence to the intervention than center-based pulmonary rehabilitation. Telehealth pulmonary rehabilitation and home-based pulmonary rehabilitation, therefore, are attractive alternatives to center-based pulmonary rehabilitation and will exponentially increase pulmonary rehabilitation capacity.

Keywords: Pulmonary rehabilitation; Telehealth.

MeSH terms

  • Dyspnea / etiology
  • Dyspnea / rehabilitation
  • Home Care Services*
  • Humans
  • Patient Compliance
  • Pulmonary Disease, Chronic Obstructive* / rehabilitation
  • Quality of Life*
  • Rehabilitation Centers
  • Telemedicine
  • Walk Test