Pulmonary rehabilitation is a cornerstone of care for people with chronic lung conditions. There is robust evidence that pulmonary rehabilitation improves exercise capacity, reduces symptoms, enhances health-related quality of life and reduces health care utilisation but the uptake of traditional centre-based pulmonary rehabilitation programs is generally low due issues including parking, transport, program location and competing needs.
Home-based pulmonary rehabilitation is an alternative model that aims to improve uptake and access and has been shown to have equivalent clinical outcomes to centre-based programs.
Reflections from patients who have completed a program:
A home-based program may be suited to people who:
Do not live near a centre-based program
Do not own a car or have difficulty with public transport
Have work commitments that do not allow them to attend a centre-based program
Have young children at home
Are a primary caregiver in their home
Would prefer not to exercise in a group
Like the flexibility of being able to exercise when it suits them
Are medically unsuitable for a group-based program e.g. immunocompromised
It may not be suited to people who:
Are medically unstable and require in-person supervision whilst exercising
Prefer to exercise with a group
The burden of frequent travel to a centre-based program, in the setting of distressing exertional dyspnoea and mobility limitation, is consistently cited by patients as a barrier to attendance.
Referrals to a home-based pulmonary rehabilitation program are made in the same way as for a centre-based program.
After the initial assessment the patient may be able to choose to attend centre-based group sessions or to exercise at home with the guidance of weekly telephone calls from a health professional. This choice will not be available to patients who require direct supervision whilst exercising or if a home-based program is not yet available.