Opinion/Feedback

With more than 700,000 patients, chronic obstructive pulmonary disease (COPD), a sickness characterized by a progressive alteration of lungs function, presents a major burden in Canada. Even though COPD is primarily a respiratory system disease, progressive sedentary lifestyle, reduced exercise capacity and a restricted participation in daily life activities, which all contribute to a poor health-related quality of life are common consequences of the disease progression.

Cornerstone of the COPD management, there is unequivocal evidence that pulmonary rehabilitation is the most effective treatment to improve shortness of breath, exercise tolerance and quality of life of patients with COPD. Since 2001, pulmonary rehabilitation is thus considered an unavoidable intervention in the treatment of lungs disease. Usually delivered on an outpatient or in-hospital basis, accessibility and adherence to this intervention strategy remains limited. Thus, despite its clinical and socio-economic relevance, several surveys across Canada and around the world show that pulmonary rehabilitation is only available for less than 2% of patients with COPD. Pulmonary rehabilitation is not even part of the range of opportunities available to patients in half of the regions of the province of Quebec.

Bringing new insights to improve health care organisation and accessibility, several studies have shown that home-based pulmonary rehabilitation are as effective and safe as rehabilitation delivered in hospital or in rehabilitation center In addition, telerehabilitation, a telehealth application that uses telecommunications technologies to rehabilitation services, is a promising new approach that could also contribute to improving accessibility and adherence to pulmonary rehabilitation.

The aim of this presentation is to report the latest consensus regarding pulmonary rehabilitation and to discuss how home-based rehabilitation and telerehabilitation could be considered to improve pulmonary rehabilitation service offering.