Evaluation of Program Adherence and Health Outcomes When Patients Self-Select to Either In-Person or Virtual Pulmonary Rehabilitation
Notice bibliographique
Résumé
Abstract Rationale: In-person pulmonary rehabilitation (PR) has long been the gold standard, fostering direct clinician-patient interactions and facilitating a supportive group environment. However, geographical limitations, mobility issues, and scheduling conflicts can hinder accessibility for some patients. Virtual PR delivered within patient's homes has emerged as a promising alternative, offering flexibility and convenience. Randomized-controlled trials as well as cohort studies conducted during the pandemic demonstrate similar outcomes derived from in-person vs. Virtual PR. A real-world limitation of this previous work is that patients were not given the choice of what type of program to attend. The purpose of this study was to compare adherence and health outcomes from virtual PR versus in-person PR when patients were able to self-select their preferred delivery modality of PR. Methods: Patients enrolled in the Breathe Easy PR Program (n=572) self-selected in-person (n=374) or virtual (n=198) PR. Both groups attended a standardized curriculum of 16 PR sessions consisting of group education and supervised exercise. Program adherence was determined via program completion and participant attendance. Health outcomes were assessed before and after PR and consisted of 6-minute walk distance (6MWD), 30-second sit-to-stand (30-sec STS), grip strength, COPD assessment test (CAT), and EQ5D health score. Results: More females self-selected virtual PR versus in-person PR (61% vs. 41%; p<0.001). At baseline, 6MWD (305±122m vs. 363±110m; p<0.001) and 30-sec STS (9.7±3.2 vs. 10.5±3.7; p=0.024) were significantly lower in virtual PR. Program completion rates were similar between virtual PR and in-person PR (79% vs. 72%; p=0.07). The primary reason for non-completion (health reasons, time or logistical constraints, or lack of interest), did not differ between groups (p=0.748). The virtual PR group attended more sessions compared to the in-person PR group (12/16 vs. 11/16; p=0.04). Both groups demonstrated similar statistically significant within-group improvements in 6MWD, 30-sec STS, CAT and EQ5D with PR, however, there were no time-by-program interactions. Conversely, a time-by-program interaction was observed for grip strength showing that in-person PR led to greater improvements in grip strength compared to virtual PR. Conclusions: More women self-select virtual PR vs. in-patient PR. Virtual PR facilitated greater program attendance, but completion rates were similar between the two programs. Self-selected virtual PR is an effective alternative to in-person PR, resulting in similar improvements in health outcomes and program adherence. Greater improvements in grip strength were observed during the in-person program, suggesting that in-person participation may facilitate greater strength benefits compared to virtual PR.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».