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Who Enrolls After Referral to Virtual Pulmonary Rehabilitation? A Descriptive Comparison
Emily A Schultz1, Madeleine Frank2, Sara L Eppler1
1VOICES Health Policy Research Center, Stanford University, Stanford, California, United States.
Chronic Obstructive Pulmonary Diseases (Miami, Fla.)
|May 22, 2026
Summary
Virtual pulmonary rehabilitation (VPR) offers accessible care for COPD patients, but enrollment challenges remain despite overcoming geographic barriers. Further research is needed to optimize VPR program accessibility and participation for chronic obstructive pulmonary disease (COPD) management.
Area of Science:
- Pulmonary Medicine
- Digital Health
- Rehabilitation Science
Background:
- Multidisciplinary management, including pharmacotherapy, patient education, and pulmonary rehabilitation (PR), is crucial for optimizing chronic obstructive pulmonary disease (COPD) outcomes.
- Virtual pulmonary rehabilitation (VPR) presents an innovative strategy to enhance access to care by overcoming geographical limitations.
Purpose of the Study:
- To characterize patients referred to a VPR program, comparing those who enrolled with those who did not.
- To identify reasons for non-enrollment in VPR.
- To assess clinical outcome changes in patients participating in VPR, analyzing differences across the Social Vulnerability Index (SVI).
Main Methods:
- A retrospective cohort study was conducted at a single academic center, analyzing data from patients with COPD referred to VPR.
- Demographic data, Social Vulnerability Index (SVI), and distance to the nearest in-person PR program were collected.
- Comparison of enrolled versus non-enrolled patients and pre- vs. post-participation outcomes were evaluated, including stratification by SVI.
Main Results:
- Out of 278 referred patients, 63 (22.7%) enrolled in the VPR program. Ineligibility accounted for 8.3% and declines for 16.2% of referrals.
- Enrolled patients averaged 76.7 years old, with a majority being female (60.3%). The mean SVI was 0.53 (medium vulnerability), and the average distance to an in-person PR center was 12.6 miles.
- No significant differences in SVI, distance, language, or race were observed between enrolled and non-enrolled groups.
Conclusions:
- VPR shows potential as an effective and accessible method for improving functional and patient-centered outcomes in COPD patients.
- Despite VPR's ability to mitigate geographic barriers, persistent obstacles hinder the expansion of PR program enrollment.
- Further strategies are needed to address barriers and increase VPR program uptake among eligible COPD patients.
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