Efficacy of a long-term m-health program for Integrated Care (MHICP) supervised by a Therapeutic Educator after pulmonary rehabilitation, in COPD patients: a pilot- randomized control trial

Abstract

Background: pulmonary rehabilitation (PR) is the most efficient non pharmacology intervention for COPD. However, to maintain its effects for a long period of time it is still a huge problem. The aim of this project is to evaluate the adherence to an integrated care program (ICP), followed after a conventional PR, to mantain its benefits. Methods: after ambulatory PR program, COPD patients were randomly allocated to a conventional follow up (CG) or MHICP that consists of a self-care education plan, including physical activity, emotional support and behaviour change. Quality of life (SGRQ and CAT), exercise tolerance (6MWD), dispnea (VAS), adherence and perception (CAP-Physio) were assessed post PR, at 6 and 12 months for the follow- up period. Results: a total of 44 COPD patients (61% male) from 3 Madrid Hospitals were included (24 CG and 20 IPP). FEV1 43,16 (13.65) vs 45.05 (15.27), CG and MHICP respectively. The multivariate analysis showed significative differences between groups in CAT (p<0.001); SGRQ simpt. (p<0.001); VAS (p=0.016) and 6MWD (p=0.004). Finally, the ICP patients presented better adherence and a good perception of the program (p<0.05, both). Conclusions: We conclude that a long term m-health program for integrated care, supervised by a therapeutic educator, could increase quality of life in COPD patients after pulmonary rehabilitation, besides improving adherence to a self-care plan and change in patients' behaviour and their perception to using these programs.