Video Telehealth Pulmonary Rehabilitation to Reduce Hospital Readmission in Chronic Obstructive Pulmonary Disease
Video Telehealth Pulmonary Rehabilitation to Reduce Hospital Readmission in Chronic Obstructive Pulmonary Disease (Tele-COPD)
University of Alabama at Birmingham
768 participants
Jun 28, 2022
INTERVENTIONAL
Conditions
Summary
The purpose of this study is to compare the efficacy and safety of a real time video telehealth pulmonary rehabilitation intervention with standard of care in patients hospitalized for an exacerbation of chronic obstructive pulmonary disease (COPD) to determine the impact on hospital readmissions and respiratory morbidity, and to investigate the cost-effectiveness of the intervention.
Eligibility
Inclusion Criteria4
- Age 40 or greater
- Clinical diagnosis of COPD
- Hospitalized for acute exacerbation of COPD.
- Be willing to adhere to trial and follow-up procedures and give informed consent
Exclusion Criteria18
- Secondary diagnosis of congestive heart failure that is severe as documented by active symptoms, New York Heart Association (NYHA) functional classification IV or left ventricular ejection fraction \<25% on echocardiography
- Other respiratory conditions that could confound the diagnosis such as asthma, pulmonary fibrosis, bronchiectasis, and lung cancer. Participants with pneumonic exacerbations of COPD will be included.
- Primary diagnosis of COVID pneumonia. Individuals with incidentally detected COVID or persistently positive for COVID but deemed to be convalescent will not be excluded.
- Active cancers on chemotherapy or radiation therapy
- Immunosuppressed states predisposing to frequent hospitalizations including uncontrolled HIV/AIDS
- Active or recent (within 1 month) myocardial infarction
- Angina not well-controlled by medication
- Unstable cardiac arrhythmias, atrial or ventricular
- Supplemental oxygen requirement greater than 5 liters per minute at either rest or with exertion
- Significant cognitive dysfunction, including dementia, that in opinion of investigator would impair ability to safely or effectively engage in study protocol
- Participants with any terminal medical illnesses as diagnosed by a physician, and/or on hospice
- Currently enrolled in and participating in pulmonary rehabilitation
- Treatment with chronic or newly initiated home ventilatory support. Those on in-patient short-term non-invasive ventilation will not be excluded.
- Special patient groups such as prisoners and institutionalized patients
- Participants with musculoskeletal comorbidities or physical infirmities that preclude participation in an exercise program
- Current participation in any other interventional clinical trial
- Inability to understand and speak English during exercise sessions
- Inability or unwillingness to comply with study and/or follow-up procedures outlined in the protocol
Interventions
Participant will be asked to exercise 3 times a week at their home for 60 minutes each session, via live two-way videoconferencing using a data-enabled smart phone or similar device. A total of 36 sessions will be administered over 13 weeks post-discharge. Sessions will be administered by exercise physiologists located at the University of Alabama at Birmingham. Each session will be scheduled with up to three other participants at a time to mimic group sessions as delivered at center-based pulmonary rehabilitation programs. Exercise sessions will include aerobics, strength or resistance training, breathing exercises, and education sessions. The exercise plans will be tailored according to the participants' baseline exercise tolerance as determined by an initial six minute walk test and their answers to the questionnaires at the baseline visit.
Locations(15)
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NCT05119556