Advancing Telehealth Pulmonary Rehabilitation for COPD: Bridging Current Practices, Individual Experiences, and...

Telehealth pulmonary rehabilitation (PR) expands access to rehabilitation services for individuals with COPD by addressing barriers to participation in center-based programs. However, it remains important to assess whether these programs follow an intervention framework that effectively enhances the well-being of individuals with COPD. This scoping review analyzed current literature on telehealth PR to identify trends and gaps in program components, delivery methods, remote monitoring, use of telehealth technology, program effectiveness, participants' subjective perceptions, and recommendations. A systematic search of databases such as PubMed, Web of Science, and Embase identified relevant studies published between January 2010 and June 2024. Eligible studies included adults (≥18 years) with COPD and used randomized controlled trials, quasi-experimental, observational, qualitative, or mixed-method designs. This review highlighted considerable heterogeneity in reporting of the baseline sociodemographic and clinical characteristics. About 50% of studies employed hybrid models combining asynchronous and synchronous interventions. Remote monitoring with Bluetooth-enabled devices was included in 46% of studies to track vital signs and activity levels. Common interventions included aerobic and resistance training (94%), aerobic training alone (34%), self-management education (70%), and health coaching (43%). Theoretically grounded health coaching showed promise in supporting self-management of symptoms and health behaviors. Despite these advances, significant gaps remain in remote assessment of functional outcomes and tailored interventions that account for diverse sociodemographic and clinical profiles. Overall, telehealth PR demonstrated noninferiority to center-based PR. The programs using a multimodal approach including exercise training, self-management education, health coaching, health care professionals, and peer support were effective in improving program adherence, health outcomes and reducing health care burden. The qualitative findings emphasized the importance of baseline technical training, tailoring programs to disease severity, and continuous support from health care providers and peers to sustain positive health behaviors.