myCOPD: Trooper Study

Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial.

We set out to obtain evidence whether the online pulmonary rehabilitation (PR) programme ‘my-PR’ is non-inferior to a conventional face-to-face PR in improving physical performance and symptom scores in patients with COPD.

We carried out a two-arm parallel single-blind, randomised controlled trial, where the online arm carried out pulmonary rehabilitation in their own homes and the face to face arm in a local rehabilitation facility. The participants included 90 patients with a diagnosis of Chronic  Obstructive Pulmonary Disease (COPD), modified Medical Research Council score of 2 or greater referred for pulmonary rehabilitation (PR), randomised in a 2:1 ratio to online (n=64)  or face-to-face PR (n=26).

The adjusted mean difference for the 6 min walk test (6MWT) between groups for the intention-to-treat (ITT) population was 23.8 m with the lower 95% CI well above the non-inferiority threshold of −40.5 m at −4.5 m with an upper 95% CI of +52.2 m. This result was consistent in the per-protocol (PP) population with a mean adjusted difference of 15 m (−13.7 to 43.8). The CAT score difference in the ITT was −1.0 in favour of the online intervention with the upper 95% CI well below the non-inferiority threshold of 1.8 at 0.86 and the lower 95% CI of −2.9. The PP analysis was consistent with the ITT.

In summary, this meant the 6-week programme of online supported PR was non-inferior to the conventional model delivered in face to face sessions in terms of effects on 6MWT distance and symptom scores, and was safe and well-tolerated.

View “Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial ” study at www.bmj.com

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