Advancing care in chronic obstructive pulmonary disease

Oct. 15, 2019

Pulmonary Medicine at Mayo Clinic is advancing the care of patients with chronic obstructive pulmonary disease (COPD) by offering a home-based pulmonary rehabilitation program that provides technology that monitors patient activity and well-being in addition to health coaching. There is no cost to participate, and the program is open to any patient with significant COPD symptoms. The program can be done regardless of where the patient resides.

Funded by the National Institutes of Health, the program is based on a landmark study led by Mayo Clinic and published in American Journal of Respiratory and Critical Care Medicine in 2016 and Respiratory Care in 2017.

"Hundreds of participants have been tested and found the technology simple and easy to use. The health coaching included in the program demonstrates that the program is effective with intervention that improves quality of life and decreases emergency department visits and hospitalizations," says Roberto P. Benzo, M.D., program director, director of the Mindful Breathing Laboratory, and a pulmonologist at Mayo Clinic's campus in Rochester, Minnesota. "Providing the patient with mindful and assertive communication supports the patients' autonomy and expertise to increase their confidence to deal with their conditions."

In the home-based pulmonary rehabilitation program, Mayo Clinic provides each patient with an activity monitor and a computer tablet on which they watch and follow simple flexibility and balance exercises while oxygen and heart rate is monitored. The activity monitor also tracks daily steps. All information gathered, including physical activity, symptoms and general messages, is available to the patient's Mayo Clinic health coach and discussed in a weekly phone call with the patient. Patients can message their health coach at any time through the computer tablet.

Research indicates that pulmonary rehabilitation completed at medical centers is a proven effective intervention for patients with COPD. Pulmonary rehabilitation improves symptoms, exercise capacity, quality of life and health care utilization.

"Unfortunately, much of current pulmonary rehabilitation is delivered in a center-based environment that has limited participation due to transportation limitations, distances traveled, and often patient frailty," says Dr. Benzo. "The home-based pulmonary rehabilitation program is a valid and equally effective alternative achieved by technology that permits clinicians to assess adherence and safety."

A study of the development and feasibility of a home-based pulmonary rehabilitation program was published in Respiratory Care in 2018.