Effectiveness of home-based pulmonary rehabilitation: Systematic review and meta-analysis

Uzzaman, Md. Nazim and Agarwal, Dhiraj and Chan, Soo Chin and Engkasan, Julia Patrick and Habib, G. M. Monsur and Hanafi, Nik Sherina and Jackson, Tracy and Jebaraj, Paul and Khoo, Ee Ming and Mirza, Fatim Tahirah and Pinnock, Hilary and Shunmugam, Ranita Hisham and Rabinovich, Roberto A. (2022) Effectiveness of home-based pulmonary rehabilitation: Systematic review and meta-analysis. European Respiratory Journal, 31 (165). ISSN 0903-1936, DOI https://doi.org/10.1183/16000617.0076-2022.

Full text not available from this repository.


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 (1800 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 0.32-1.44; p=0.002) and HRQoL (SMD -0.62, 95% CI -0.88--0.36; p<0.001). Compared to centre-PR, home-PR showed no significant difference in exercise capacity (SMD -0.10, 95% CI -0.25-0.05; p=0.21) or HRQoL (SMD 0.01, 95% CI -0.15- 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.

Item Type: Article
Funders: National Institutes of Health Research (NIHR), GlobalHealth Research Unit on Respiratory Health (RESPIRE), UK Government, NIHR Global Health Research Unit on Respiratory Health (RESPIRE)
Uncontrolled Keywords: Quality-of-life; Training-programs; COPD; Disease; Outpatient
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 30 Aug 2023 07:32
Last Modified: 30 Aug 2023 07:32
URI: http://eprints.um.edu.my/id/eprint/41093

Actions (login required)

View Item View Item