Chronic obstructive pulmonary disease (COPD) is one of the main causes of morbidity and mortality worldwide. Pulmonary rehabilitation (PR) is considered a critical part of COPD treatment, reducing breathlessness, increasing health-related quality of life, and decreasing health care utilization. However, only a small portion of patients with COPD access PR due to transportation issues, or the frailty of patients. Home-based PR has been found useful, but has not been implemented due to the lack of available PR programs and systems which continuously monitor the patient's safety and progress. Self-management support (SM), as proposed in the chronic care model and in international COPD guidelines, is not widely implemented. Pulmonary rehabilitation represents a unique opportunity for SM given the meaningful engagement and communication existing with a care provider through the program. In this application, we propose to test the effectiveness of a home-based PR system developed in our previous research project which would make PR feasible in the patient's own home with accurate monitoring and feedback and SM support through a health coach. The proposed system fills a knowledge/practice gap in COPD care by increasing access to PR which may translate to improved well-being and heath care outcomes. This simple, yet highly innovative home?based PR system which uses commercially available monitors will promote higher adherence to PR and to SM support and lead to a sustained improvement of well-being.

Public Health Relevance

Pulmonary Rehabilitation (PR) is considered a critical part of chronic obstructive pulmonary disease (COPD) treatment, reducing breathlessness, increasing health-related quality of life, and decreasing health care utilization. However, only a small portion of patients with COPD access PR, most commonly due to transportation issues or frailty. In this application we propose to test the effectiveness of a home-based PR system plus health coaching that aims to improve quality of life, daily physical activity, and self-management.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL140486-03
Application #
9856508
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Punturieri, Antonello
Project Start
2018-03-05
Project End
2023-01-31
Budget Start
2020-02-01
Budget End
2021-01-31
Support Year
3
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905