Telerehabilitation for people with chronic respiratory disease: A qualitative evaluation of the patient experience.

Abstract

Introduction/Aim: Remotely delivered pulmonary rehabilitation, telerehabilitation, has the capacity to increase access to rehabilitation services. However, remote rehabilitation may limit opportunities for social interaction for people with chronic respiratory disease. This work aimed to gain an in-depth understanding of the perceptions and experience of patients undertaking an 8-week, home-based, supervised telerehabilitation program. Methods: Individuals undertaking telerehabilitation as a part of a larger randomized controlled equivalence trial were invited to undertake a 1:1 semi-structured interview. Audio recordings of interviews were transcribed verbatim and thematically coded to identify major themes and sub-themes. Results: 30 individuals (42% of all telerehabilitation participants) undertook interviews between November 2018 and May 2020. Participants had COPD (n = 22), ILD (n = 2), bronchiectasis (n = 3) and asthma (n = 3); mean (SD) age 67 (7) years and FEV1 57 (25) %predicted. Three were current smokers and 33% were from a rural location. Five major themes, with subthemes, were identified, being: 1. ‘Making it easier to participate in pulmonary rehabilitation’—convenient and comfortable to exercise at home, as well as time and cost saving; 2. ‘Telerehabilitation offers support in a variety of ways’—company of other patients with common experiences; knowledge and reassurance of staff, and receiving an individually tailored program; 3. ‘Motivation to exercise’—distraction, competition and inspiration provided by group, and seeing results for effort; 4. ‘Setting people up for success’—good communication, streamlined processes and support for equipment and technology; and. 5. ‘After rehabilitation’—desire for a longer program and recommendations to others. Conclusion: People with chronic respiratory disease thought telerehabilitation made it easier for them to undertake pulmonary rehabilitation, and felt well supported by clinicians and their peers. The company and interaction with other patients and staff were considered to be like being in a face-to-face group and provided motivation for exercise.