Use the Back button in your browser to see the other results of your search or to select another record.
Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis |
Uzzaman MN, Agarwal D, Chan SC, Patrick Engkasan J, Habib GMM, Hanafi NS, Jackson T, Jebaraj P, Khoo EM, Mirza FT, Pinnock H, Shunmugam RH, Rabinovich RA |
European Respiratory Review 2022 Sep;31(165):220076 |
systematic review |
INTRODUCTION: 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. METHODS AND ANALYSIS: 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. RESULTS: We identified 16 studies (1,800 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 to 1.44; p = 0.002) and HRQoL (SMD -0.62, 95% CI -0.88 to -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 to 0.05; p = 0.21) or HRQoL (SMD 0.01, 95% CI -0.15 to 0.17; p = 0.87). CONCLUSION: 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.
|