The Effectiveness of Tele-pulmonary Rehabilitation Program on People With Chronic Obstructive Pulmonary Disease (COPD) After Hospitalization for Acute Exacerbation

Introduction: There are great impacts of chronic obstructive pulmonary disease (COPD) over healthcare and economic systems globally. Managing COPD stably in community is still a challenging topic due to its progressive nature, it is valuable to be studied with a view to improving the health status and quality of life in people with COPD and thus relieving the healthcare and economic burdens. Pulmonary rehabilitation (PR) was proven to be cost-effective with clinical benefits in optimizing quality of life, physical conditions and reducing hospital re-admissions rate in people with COPD. Traditionally, PR training was conducted under professional supervision in a face-to-face format. Community-based PR, like tele-rehabilitation, centre-based and homebased rehabilitation are emerging as an effective alternative to traditional PR. Promoting community-based rehabilitation is possibly one of the ways to engage people with chronic diseases in selfmanagement at their doorstep, which will help to tackle the escalating aging population and their heavy burden to the public healthcare system in Hong Kong.

Objectives: The objectives of this study are:

• To evaluate the clinical effectiveness of the newly developed tele-pulmonary rehabilitation program on people with COPD after hospitalized acute exacerbation,
• To explore participants' experience towards the program and develop a deeper understanding about the enablers and barriers faced by participants in joining the - tele-pulmonary rehabilitation program for quality assessment and improvement Methodology: Quasi-experimental design will be adopted in quantitative study, participants will join an eight-session tele-PR program in the intervention group, and participants will join the control group when pending for traditional out-patient based PR program. Purposive sampling will be adopted, participants should be clinically diagnosed COPD, able to participate in scheduled PR program and able to listen, speak, read and understand Chinese. Four domains of outcome measures will be collected, including participant profile, physical health status, health-related quality of life and healthcare resources utilization, for evaluation. Qualitative study with phenomenological approach will be adopted to discover participants' experience in the service. Semistructured, individual face-to-face in-depth interviews will be conducted once participants complete the tele-pulmonary rehabilitation program. Significance: This study will provide solid evidence on the effectiveness of tele-pulmonary rehabilitation program for people with COPD after hospitalized for acute exacerbation.