Integrating remote patient monitoring into pulmonary rehabilitation: a feasibility randomised controlled trial

Digital remote patient monitoring (DRPM) may enhance pulmonary rehabilitation (PR) by supporting continuous symptom tracking and early intervention, key features of effective disease management. This study examined the feasibility of integrating DRPM within a structured PR programme.

This was a parallel-group, single-centre, cluster-randomised clinical trial embedded within a quality improvement initiative. Patients were allocated to Standard-PR (16 PR sessions delivered over 6 or 8 weeks) or PR+DRPM. In addition to Standard-PR, the PR+DRPM group remotely monitored and transmitted blood pressure, heart rate, oxygen saturation, body temperature and weight data daily to PR staff during PR and for 12 weeks post-PR. Feasibility outcomes included recruitment, retention, adherence, acceptability, patient safety and impact on clinician workload. Secondary outcomes explored whether DRPM influenced self-management behaviours while preserving established benefits of PR.

78 of 83 eligible patients approached were enrolled (94% recruitment rate; 55% male; mean±sd age 68.4±11 years; mean±sd forced expiratory volume in 1 s 59.1±22.7% predicted). Participant retention was 77% post-PR and 68% at the 12-week follow-up, with similar rates between groups. DRPM adherence was 90% during PR and 89% at follow-up. 100% of participants would recommend DRPM to other patients. A total of 163 compliance calls were made by the vendor. PR staff workload increased by 45 min per participant in the PR+DRPM group addressing DRPM-generated alerts.

Integrating DRPM into PR was feasible based on pre-specified benchmarks, but substantially increased provider workload, underscoring the need for workflow optimisation before initiating a larger trial.