Use of tablets offering training diaries, exercise videos and training results may help improve patient attendance in pulmonary rehab programs

Jones A, Taylor A, Gowler H, et al.  Systematic review of interventions to improve patient uptake and completion of pulmonary rehabilitation in COPD ERJ Open Research. 2016 Aug; 6(8).

Review question

• How can attendance and completion of pulmonary rehabilitation, a program which includes patient-centred interventions such as exercise therapy and education, be improved among patients with Chronic Obstructive Pulmonary Disorder (COPD)?

Background

• The positive effects of pulmonary rehabilitation on patient health is well known, however, only some of the referred patients actually attend. In the U.K., only 42% of referred patients attend pulmonary rehabilitation.
• Currently, patients referred to pulmonary rehabilitation elect not to attend for reasons such as difficulty in travel and transport, a poor understanding of their illness, and a lack of understanding of the benefits of rehabilitation, among others.
• By understanding the reasons patients elect to not attend pulmonary rehabilitation and identifying interventions to address these barriers, patient health can be improved.

How the review was done

• A detailed search of 13 electronic databases for studies was conducted. Studies that were randomized controlled trials focusing on the use of any intervention to improve attendance among patients referred to pulmonary rehabilitation were included in the review.
• A total of 2,914 articles were identified in searches, and one study was included in the review after assessments for eligibility.
• The review was funded by the University of Lincoln Research Investment Fund for the Lincolnshire Joint Research Agenda on COPD.

What the researchers found

• The review included only one study which looked at the use of a training diary, exercise videos and training results on a tablet computer to improve patient attendance at pulmonary rehabilitation programs.
• These techniques helped improve the rate of patient attendance at a notable level, and increased the likelihood of success for pulmonary rehabilitation in the patients.
• There is a need for more high-quality research in order to consolidate these findings and to establish further ways to improve patient attendance.

Conclusion

• This review found that research focused on interventions aimed at improving adherence to pulmonary rehabilitation programs among patients with COPD is sparse. The findings of one study point to increased patient attendance and likelihood of completion of pulmonary rehabilitation due to the use of tablet computers with training diaries, exercise videos and training results. Further research is required before informing clinical practices.