Home- Based Pulmonary Rehabilitation For Patients With Chronic Respiratory Diseases In Malaysia: A Feasibility Study

Clinical Research Results Abstract IntroductionChronic respiratory diseases (CRDs) are growing problems worldwide with rising mortality and morbidity. Pulmonary rehabilitation (PR) has proven health benefits for patients with CRDs, but programmes need to be adapted to low resource settings and, in the context of the recent COVID-19 pandemic, to home-based delivery.AimTo evaluate the feasibility of delivering a home-based PR programme for patients with CRDs in Malaysia. MethodsWe recruited people with CRD from two hospitals in Klang Valley, Malaysia to a home-based PR programme. Following a Centre-based assessment, patients were required to perform exercise at least five sessions per week for 8 weeks at home (total 40 sessions). We supervised the patients via weekly telephone calls. Education sessions were provided prior to the programme. We assessed the attendance and retention rate of patients. At before and after Centre-based assessments we measured functional exercise capacity (6-Minutes walking test (6MWT)) and Health-Related Quality of Life (HRQOL) (COPD Assessment Test (CAT)) . Data were analysed via SPSS.ResultsWe recruited 30 patients to the programme. The retention rate to the exercise sessions was 19/30 (63.3%); but only 11/30 (36.7%) of the patients attended the follow-up assessment at 9-weeks. 9/11 (81.8%) of these had attended all 40 sessions. Attendance at the post-PR assessment was limited because COVID-19 restrictions forbade travel in Malaysia at the 9-week timepoint. Data from the 11 patients able to attend showed a significant change in the CAT scores of 5.09 (95% confidence interval (CI) 1.48-8.70, p=0.01) but no significant change in the 6MWT distance -24.36 (95% CI -80.52,-31.79, p=0.356).ConclusionHome-based PR proved to be feasible despite COVID-19, and enabled socially distanced delivery of the programme. Pandemic-related movement restrictions prevented most of the post-PR assessments. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Funding:This research was commissioned by the UK National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE), using UK Aid from the UK Government. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.Competing interests: EMK reports grants from the National Institute for Health Research Global Health Research Unit on Respiratory Health (RESPIRE) and Seqirus UK; personal fees from AstraZeneca and GlaxoSmithKline; and is board director of the International Primary Care Respiratory Group References and Clinical Trial Registry Information