Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review.
Túlio Medina Dutra de Oliveira, Adriano Luiz Pereira, Giovani Bernardo Costa and 4 others
PMID 36188941WHAT IT FOUND
Home and community pulmonary rehabilitation improved exercise capacity and quality of life for people with COPD, though often less than hospital-based programs.
Home-based care offered flexibility and reduced travel burdens, while community settings provided social support.
Key findings
01Home-based pulmonary rehabilitation improved exercise capacity in 22 studies and quality of life in 14 studies compared to control groups.
02Community-based pulmonary rehabilitation improved exercise capacity in 4 studies compared to usual care, but only 1 study found a significant improvement in quality of life.
03Telerehabilitation was safe and acceptable, with participants reporting ease in handling monitoring technology, though dropout rates were higher for those with severe disease or anxiety.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review searched only one database (MEDLINE) and included only English-language articles, which may have missed relevant studies. Study selection and data extraction were performed by single authors, increasing the risk of error. No formal risk of bias assessment was conducted due to the rapid review design. The included studies varied widely in intervention components, supervision frequency, and duration, making direct comparisons difficult.
Declared interests
The authors declared no commercial or financial relationships that could be construed as a potential conflict of interest. Funding was provided by the Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES).
The easy way to misread this
Do not assume home or community programs are equivalent to hospital-based care for all patients. The review notes that benefits were often less pronounced in alternative settings, and patients with severe disease or complex comorbidities may require the higher level of supervision and resources available in hospital-based programs.