Home-based model with one home visit and seven telephone calls at least as good as hospital PR
MONDAY, May 16, 2016 (HealthDay News) — For patients with stable chronic obstructive pulmonary disease (COPD), home-based pulmonary rehabilitation (PR) is associated with short-term clinical outcomes that are at least equivalent to those of hospital PR programs, according to a study presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.
Anne E. Holland, Ph.D., from Alfred Health and La Trobe University in Melbourne, Australia, and colleagues conducted a randomized controlled equivalence trial involving 166 patients with stable COPD who received eight-weeks of PR, delivered via a standard outpatient center-based model or a home-based PR model. The home-based intervention included one home visit and seven once-weekly telephone calls that employed a motivational interviewing approach.
The researchers observed no significant between-group differences at any time point in clinical outcomes. Noninferiority of home-based PR was confirmed in the change in six-minute walk distance; the confidence interval did not rule out superiority (mean difference between the groups, 18.60 m; 95 percent confidence interval, −3.55 to 40.71 m). The confidence interval did not exclude inferiority of home-based PR at 12 months (−5.14 m; 95 percent confidence interval, −29.40 to 19.13 m). At 12 months, neither group had maintained post-rehabilitation gains. The costs of delivery were $219 and $209 for hospital and home-based PR, respectively.
“We would need appropriate funding models that recognize a telephone call from a health care professional can be a treatment,” Holland said in a statement.
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