Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis.
Journal
European respiratory review : an official journal of the European Respiratory Society
ISSN: 1600-0617
Titre abrégé: Eur Respir Rev
Pays: England
ID NLM: 9111391
Informations de publication
Date de publication:
30 Sep 2022
30 Sep 2022
Historique:
received:
27
04
2022
accepted:
14
06
2022
entrez:
21
9
2022
pubmed:
22
9
2022
medline:
24
9
2022
Statut:
epublish
Résumé
Despite proven effectiveness for people with chronic respiratory diseases, practical barriers to attending centre-based pulmonary rehabilitation (centre-PR) limit accessibility. We aimed to review the clinical effectiveness, components and completion rates of home-based pulmonary rehabilitation (home-PR) compared to centre-PR or usual care. Using Cochrane methodology, we searched (January 1990 to August 2021) six electronic databases using a PICOS (population, intervention, comparison, outcome, study type) search strategy, assessed Cochrane risk of bias, performed meta-analysis and narrative synthesis to answer our objectives and used the Grading of Recommendations, Assessment, Development and Evaluations framework to rate certainty of evidence. We identified 16 studies (1800 COPD patients; 11 countries). The effects of home-PR on exercise capacity and/or health-related quality of life (HRQoL) were compared to either centre-PR (n=7) or usual care (n=8); one study used both comparators. Compared to usual care, home-PR significantly improved exercise capacity (standardised mean difference (SMD) 0.88, 95% CI 0.32-1.44; p=0.002) and HRQoL (SMD -0.62, 95% CI -0.88--0.36; p<0.001). Compared to centre-PR, home-PR showed no significant difference in exercise capacity (SMD -0.10, 95% CI -0.25-0.05; p=0.21) or HRQoL (SMD 0.01, 95% CI -0.15-0.17; p=0.87). Home-PR is as effective as centre-PR in improving functional exercise capacity and quality of life compared to usual care, and is an option to enable access to pulmonary rehabilitation.
Identifiants
pubmed: 36130789
pii: 31/165/220076
doi: 10.1183/16000617.0076-2022
pmc: PMC9724887
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright ©The authors 2022.
Déclaration de conflit d'intérêts
Conflict of interest: M.N. Uzzaman has nothing to disclose. Conflict of interest: D. Agarwal has nothing to disclose. Conflict of interest: S.C. Chan has nothing to disclose. Conflict of interest: J. Patrick Engkasan has nothing to disclose. Conflict of interest: G.M.M. Habib owns a Pulmonary Rehabilitation clinic in Bangladesh. Conflict of interest: N.S. Hanafi has nothing to disclose. Conflict of interest: T. Jackson has nothing to disclose. Conflict of interest: P. Jebaraj has nothing to disclose. Conflict of interest: E.M. Khoo reports grants from UK National Institute for Health Research (NIHR) Global Health Research Unit, during the conduct of the study; personal fees from AstraZeneca, personal fees and non-financial support from GlaxoSmithKline plc, and grants from Seqirus UK Ltd, and is President of the International Primary Care Respiratory Group, UK, outside the submitted work. Conflict of interest: F.T. Mirza has nothing to disclose. Conflict of interest: H. Pinnock reports grants from National Institute of Health Research (16/136/109 (2017-2021), during the conduct of the study. Conflict of interest: R.H. Shunmugam has nothing to disclose. Conflict of interest: R.A. Rabinovich has nothing to disclose.
Références
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
ERJ Open Res. 2021 Jul 12;7(3):
pubmed: 34262967
Respir Care. 2015 Apr;60(4):526-32
pubmed: 25269680
Can Respir J. 1999 Jan-Feb;6(1):55-63
pubmed: 10202221
Cad Saude Publica. 2016 Jun 20;32(6):
pubmed: 27333130
Respir Med. 2013 Aug;107(8):1195-200
pubmed: 23702089
ERJ Open Res. 2017 Jan 30;3(1):
pubmed: 28154821
Thorax. 2018 Jan;73(1):29-36
pubmed: 28756402
J Physiother. 2017 Apr;63(2):84-93
pubmed: 28433238
Eur Respir J. 2014 Dec;44(6):1428-46
pubmed: 25359355
Multidiscip Respir Med. 2010 Dec 20;5(6):401-8
pubmed: 22958267
Arch Bronconeumol. 2008 Oct;44(10):512-8
pubmed: 19006630
J Cardiopulm Rehabil Prev. 2015 Nov-Dec;35(6):380-9
pubmed: 26034937
Swiss Med Wkly. 2010 Sep 01;140:w13067
pubmed: 20809435
Lancet Respir Med. 2020 Jun;8(6):585-596
pubmed: 32526187
J Asthma. 2006 Sep;43(7):513-9
pubmed: 16939991
Respir Care. 2021 Apr;66(4):686-698
pubmed: 33531356
Cochrane Database Syst Rev. 2016 Dec 08;12:CD005305
pubmed: 27930803
Health Aff (Millwood). 2016 Sep 1;35(9):1564-71
pubmed: 27605634
Heart Lung. 2020 Nov - Dec;49(6):959-964
pubmed: 32709500
Cochrane Database Syst Rev. 2002;(3):CD002166
pubmed: 12137647
Respir Care. 2008 Sep;53(9):1185-9
pubmed: 18718037
PLoS One. 2021 Apr 21;16(4):e0249786
pubmed: 33882094
Eur Respir J. 2019 May 18;53(5):
pubmed: 30846476
Thorax. 2017 Jan;72(1):57-65
pubmed: 27672116
COPD. 2015 Apr;12(2):144-53
pubmed: 24984085
Cochrane Database Syst Rev. 2015 Feb 23;(2):CD003793
pubmed: 25705944
Clin Rehabil. 2004 Jun;18(4):444-9
pubmed: 15180129
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
Br J Community Nurs. 2013 Aug;18(8):398, 400-3
pubmed: 24225475
Int J Chron Obstruct Pulmon Dis. 2016 Jun 02;11:1161-9
pubmed: 27330284
Int J Chron Obstruct Pulmon Dis. 2016 Nov 11;11:2821-2829
pubmed: 27956829
BMJ. 2005 Nov 5;331(7524):1064-5
pubmed: 16230312
COPD. 2022 Dec;19(1):18-46
pubmed: 35000507
Braz J Phys Ther. 2014 Mar-Apr;18(2):165-73
pubmed: 24838809
Eur Respir J. 2000 Mar;15(3):517-25
pubmed: 10759446
Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):180-182
pubmed: 32164083
BMC Med Inform Decis Mak. 2016 Feb 25;16:26
pubmed: 26911326
Braz J Phys Ther. 2021 Jan-Feb;25(1):40-47
pubmed: 32007324
Eur Respir J. 2019 Apr 25;53(4):
pubmed: 30792342
ERJ Open Res. 2015 Oct 06;1(2):
pubmed: 27730157
BMJ Open. 2021 Oct 12;11(10):e050362
pubmed: 34642195
Indian J Chest Dis Allied Sci. 2003 Jan-Mar;45(1):13-7
pubmed: 12683707
Med Sci Sports Exerc. 2004 Oct;36(10):1667-73
pubmed: 15595285
Am J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64
pubmed: 24127811
BMJ Open. 2015 Jul 07;5(7):e008031
pubmed: 26152326
Trials. 2017 Jun 20;18(Suppl 3):280
pubmed: 28681707
Respirology. 2018 Mar;23(3):272-283
pubmed: 29194864
Chron Respir Dis. 2011;8(2):89-99
pubmed: 21596892
Ann Thorac Med. 2016 Apr-Jun;11(2):121-7
pubmed: 27168860
NPJ Prim Care Respir Med. 2016 Sep 15;26:16051
pubmed: 27629237
Respirology. 2017 May;22(4):800-819
pubmed: 28339144
NPJ Prim Care Respir Med. 2020 Nov 19;30(1):52
pubmed: 33214560
Ann Intern Med. 2008 Dec 16;149(12):869-78
pubmed: 19075206
Cochrane Database Syst Rev. 2021 Jan 29;1:CD013040
pubmed: 33511633
Thorax. 2020 May;75(5):413-421
pubmed: 32229541
J Clin Nurs. 2018 Mar;27(5-6):e1022-e1037
pubmed: 29076609
Cochrane Database Syst Rev. 2014 Oct 06;(10):CD006322
pubmed: 25284270
J Cardiopulm Rehabil. 2005 Nov-Dec;25(6):378-85
pubmed: 16327534
Ann Thorac Med. 2010 Jan;5(1):18-25
pubmed: 20351956
Physiother Res Int. 2018 Oct;23(4):e1740
pubmed: 30168228
Am J Respir Crit Care Med. 2015 Dec 1;192(11):1373-86
pubmed: 26623686
Rev Mal Respir. 2011 Sep;28(7):864-72
pubmed: 21943531
Thorax. 2013 Sep;68 Suppl 2:ii1-30
pubmed: 23880483
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120