Outcomes of Virtual Pulmonary Rehabilitation in Oxygen-Dependent COPD Patients

Virtual pulmonary rehabilitation (PR) is a proven yet underutilized intervention in chronic obstructive pulmonary disease (COPD) patients. However, neither the safety nor the effectiveness of virtual PR is established for patients with advanced disease and higher disease severity, particularly those requiring supplemental oxygen. We performed a retrospective review of 167 patients to evaluate the feasibility, safety, and effectiveness of virtual PR in oxygen-dependent versus nonoxygen-dependent COPD patients. Our primary outcome, attendance, was high (88% of sessions were attended by both groups). Adverse events occurred in only 2 (1%) participants, one in each group. Both groups showed significant postintervention improvements in dyspnea and depression scores (COPD Assessment Test [CAT], modified Medical Research Council [mMRC], Patient Health Questionnaire-9 [PHQ-9]) and functional exercise capacity (1-minute sit-to-stand [1MSTS]), with the improvements approaching or exceeding the established minimal clinically important difference values. When comparing the oxygen-dependent and nonoxygen groups, there were no significant differences in the degree of improvement for CAT, PHQ-9, and 1MSTS. For mMRC, those on oxygen did improve by 0.3 less than those not on oxygen (P=0.052). These findings suggest virtual PR is safe and effective for COPD patients requiring oxygen. To our knowledge, this is the first study to compare outcomes of virtual PR in patients on and off oxygen. Future research should explore patient-specific factors that can further individualize care.