Abstract:
Purpose: Pulmonary rehabilitation (PR) is vital in the management of chronic respiratory disorders (CRDs) although uptake,
attendance and completion are poor. Differing models of delivering PR are emerging in an attempt to increase the uptake and
completion of this intervention. This study aimed to evaluate participant rate of attendance and completion of PR when given
a preference regarding model of delivery (centre-based and mPR). Secondary aims were to evaluate the factors affecting patient
preference for model of delivery and determine whether mPR is non-inferior to centre-based PR in health outcomes.
Methods: A multi-centre non-inferiority preference based clinical trial in Auckland, New Zealand. Participants with a CRD referred for
PR were offered the choice of centre-based or mHealth PR (mPR). The primary outcome was completion rate of chosen intervention.
Results: A total of 105 participants were recruited to the study with 67 (64%) preferring centre-based and 38 (36%) mPR. The odds of
completing the PR programme were higher in the centre-based group compared to mPR (odds ratio 1.90 95% CI [0.83–4.35]). Participants
opting for mPR were significantly younger (p = 0.002) and significantly more likely to be working (p = 0.0001). Results showed that mPR was
not inferior to centre-based regarding changes in symptom scores (CAT) or time spent in sedentary behaviour (SBQ). When services were
forced to transition to telehealth services during COVID-19 restrictions, the attendance and completion rates were higher with telephone calls
and video conferencing compared to mPR – suggesting that synchronous interpersonal interactions with clinicians may facilitate the best
attendance and completion rates.
Conclusion: When offered the choice of PR delivery method, the majority of participants preferred centre-based PR and this
facilitated the best completion rates. mPR was the preferred choice for younger, working participants suggesting that mPR may offer
a viable alternative to centre-based PR for some participants, especially younger, employed participants.
