Background: An essential element in the treatment of patients with chronic obstructive pulmonary disease (COPD)\nis rehabilitation, of which supervised training is an important part. However, not all individuals with severe COPD\ncan participate in the rehabilitation provided by hospitals and municipal training centres due to distance to the\ntraining venues and transportation difficulties. The aim of the study was to assess the feasibility of an individualized\nhome-based training and counselling programme via video conference to patients with severe COPD after\nhospitalization including assessment of safety, clinical outcomes, patients� perceptions, organisational aspects and\neconomic aspects.\nMethods: The design was a pre- and post-test intervention study. Fifty patients with severe COPD were included.\nThe telemedicine training and counselling included three weekly supervised exercise sessions by a physiotherapist\nand up to two supervised counselling and training sessions in energy conservation techniques by an occupational\ntherapist. The telemedicine videoconferencing equipment was a computer containing a screen, a microphone, an\non/off switch and a volume control.\nResults: Thirty seven (74%) participants completed the programme, with improvements in health status assessed\nby the Clinical COPD Questionnaire and physical performance assessed by a sit-to-stand test and a timed-up-and-go\ntest. There were no cases of patient fall or emergency contact with a general practitioner during the telemedicine\ntraining sessions. The study participants believed the telemedicine training and counselling was essential for getting\nstarted with being physically active in a secure manner. The business case showed that under the current financing\nsystem, the reimbursement to the hospital was slightly higher than the hospital expenditures. Thus, the business case\nfor the hospital was positive. The organizational analysis indicated that the perceptions of the staff were that the\ntelemedicine service had improved the continuity of the rehabilitation programme for the patients and enabled\nthe patients� everyday lives to be included in the treatment.\nConclusions: This study showed that home-based supervised training and counselling via video conference is safe\nand feasible and that telemedicine can help to ensure more equitable access to supervised training in patients\nwith severe COPD.
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