A program that delivers pulmonary rehabilitation via video-conferencing technology, the internet and other emerging technologies to patients who live too far from respiratory therapy centers to make the twice-weekly trip improves their clinical condition, outcome and quality of life in just eight weeks, according to a study to be presented at the American Thoracic Society's 2008 International Conference in Toronto on May 20.
The "TELEHEALTH" program shows similar results over standard in-person pulmonary rehabilitation, according to Tina Jourdain, R.R.T., a respiratory therapist with the program. "The Edmonton-based 'Breathe Easy' Pulmonary Rehabilitation Program has been providing services to patients with chronic lung disease (CLD) for over 15 years. Referrals have increased over the years, [but] many rural patients have been unable to access our program due to its location," said Ms. Jourdain. "Therefore in 2005, Capital Health, with grant funding support from Alberta Health and Wellness, implemented the TELEHEALTH Pulmonary Rehabilitation program to expand access to patients with CLD living in rural regions within Northern and Central Alberta. This research was to compare statistics of the local program to that of the TELEHEALTH program to ensure that this new and innovative method of delivery is effective."
The majority of patients referred suffer from chronic obstructive pulmonary disease (COPD). According to the Canadian Thoracic Society, only 98 pulmonary rehabilitation facilities exist in Canada, with the capacity to serve just 1.2 percent of Canada's COPD population. Because a great many of Canadian COPD patients live in rural areas out of these centers, expanding the reach of such programs is critical.
TELEHEALTH allows patients to consult with pulmonologists, respiratory therapists and engage in a guided exercise program using video and communications technologies to avoid the need to travel long distances. To assess its effectiveness, the research analyzed the results of 113 rural patients who completed the TELEHEALTH program for eight weeks. All patients were seen by a pulmonologist via TELEHEALTH at the start of the program for a proper evaluation.
On two days a week, the patients attended educational sessions administered by TELEHEALTH at their local healthcare center and exercised under direct supervision by a respiratory therapist or physical therapist at any community center with exercise space. Of those who completed the eight-week program, there were significant improvements in the 12-minute walk distance and in quality of life as measured by St. George's Respiratory Questionnaire.
"The results were similar between local programs and the TELEHEALTH program," said Ms. Jourdain. "Many patients are hesitant to exercise without supervision out of the fear of 'doing more harm than good' when they experience shortness of breath," she explained. "This results in the patient becoming more sedentary and deconditioned. With the TELEHEALTH program, the patient is monitored and builds knowledge and self-confidence to do exercise regularly, which in turn improves their physical condition and their quality of life as well."
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