Adherence and Practical Challenges of Long-Term Telerehabilitation in COPD Patients: A Mixed-Method Study.

Abstract

Telerehabilitation (TR) increases accessibility towards pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) patients. It appears to be a cost-effective alternative to PR. We aimed to study adherence of COPD patients participating in long-term TR and practical challenges of TR from professional ́s perspective. 40 COPD patients participated in TR for 2 years. Participants performed training exercise and registered their training and daily observations in a webpage. We measured adherence by calculating frequency of registrations. Eight semi-structured interviews with professionals were conducted to explore practical challenges of TR. The Framework Method was used to analyze the qualitative data from these interviews. On average, adherence to training exercise was 1.8 sessions/week (recommended of 3 times/week) and adherence to daily observations was 2.9 registrations/week (recommendation 7 times/week). Six categories were identified by using the framework analysis: acceptance of telerehabilitation by participants and professionals, characteristics of participants, ethical and privacy-related issues, logistic issues, suggestions for improvement, and technical issues. Participants managed to adhere to training exercises and daily registration of symptoms to a great extent, thus integrating TR into their everyday life. Professionals faced many practical challenges, including technical, logistic and Internet-related issues, along with ethical and privacy-related issues. Both participants and professionals accepted and appreciated TR.