Comprehensive Health Informatics Engagement Framework for Pulmonary Rehabilitation

Research Objectives: The Comprehensive Health Informatics Engagement Framework for Pulmonary Rehabilitation (CHIEF-PR) was introduced to facilitate PR referrals, initial assessments, completion rates, and PR maintenance in patients with COPD after an acute exacerbation (AECOPD). The objective of this study was to demonstrate in a randomized controlled trial that CHIEF-PR is effective in increasing the use of PR in patients after AECOPD.

Design: Patients were followed for 12 months.

Setting: To enhance patient safety in the post-pandemic period, a protocol for remote assessment of exercise capacity was implemented, allowing patient assessment to be successfully conducted at their homes.

Participants: Overall, 120 patients were enrolled in the study. The mean age was 70±12 years old; 56% were females, 36% were Black, and 60% spent 12 years or less in school.

Interventions: The CHIEF-PR supports a multilevel approach that addresses current barriers to PR uptake and completion. On the healthcare level, it uses data from electronic health records for clinical decision support to identify COPD patients eligible for PR; on the provider level, it helps heighten provider awareness about PR; and on the patient level, it supports home-based telerehabilitation that empowers patients with interactive information about benefits of PR and engages them daily in following their individualized pulmonary PR program.

Main Outcome Measures: Outcomes included exercise capacity, respiratory symptoms, behavioral variables, QoL, and urgent care utilization.

Results: Preliminary analysis of the study results demonstrated increased participation and higher PR completion rates in the intervention group compared to the control group. The patients in the intervention group showed more prominent improvements in exercise capacity as measured by the 60-sec Sit to Stand Test and Arm Lift Test, a decrease in dyspnea score, and COPD symptoms. COPD self-efficacy, exercise motivation, and satisfaction with PR were higher in the intervention group and the physical functioning dimension of the general quality of life. The patients in the intervention group demonstrated lower urgent care utilization.

Conclusions: Pulmonary telerehabilitation is well accepted by patients and results in the improvement of patient-reported outcomes.

Author(s) Disclosures: none