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Background and Objective: There is no strong evidence on the optimal duration of pulmonary rehabilitation (PR) programmes. The aim of the study was to determine whether an 8‐week PR programme was equivalent to a 12‐week PR programme in improving endurance exercise capacity in people with chronic obstructive pulmonary disease (COPD). Methods: Participants with COPD were randomized to either an 8‐week (8‐wk Group) or 12‐week (12‐wk Group), twice weekly, supervised PR programme consisting of endurance and strength training and individualized self‐management education. Between group comparisons were made at completion of each programme (i.e., week 8 or week 12), for both programmes at week 12, and at 6–12‐month follow‐up. The primary outcome was endurance exercise capacity measured by the endurance shuttle walk test (ESWT) with the minimally important difference of 186 s set as the equivalence limit. Results: Sixty‐six participants [mean (SD); age 69 (7) years, FEV1 48 (17) %predicted] were randomized (33 per group). Between‐group comparisons demonstrated that the ESWT time was equivalent for the 12‐wk Group compared to the 8‐wk Group at programme completion [mean (95% CI)] [71 s (−61 to 203)], week 12 [70 s (−68 to 208)], and 6–12‐month follow‐up [93 s (−52 to 239)], though superiority of the 12‐wk Group could not be ruled out at each time point. Conclusion: Equivalence was shown between 8‐and 12‐week PR programmes for endurance exercise capacity, but superiority could not be ruled out for the 12‐wk Group. Decisions about programme duration may depend on local waitlist times, healthcare budgets and patient preference. In people with COPD, an 8‐week and 12‐week PR programme were equivalent at improving endurance exercise capacity at programme completion, week 12 and 6–12‐month follow‐up, though superiority of the 12‐week PR programme could not be ruled out. [ABSTRACT FROM AUTHOR]

Rationale: New pulmonary rehabilitation models can improve access to this effective but underused treatment for people with chronic respiratory disease; however, cost-effectiveness has not been determined. Objectives: To compare the cost-effectiveness of telerehabilitation, including videoconferencing and synchronous supervision, with standard center-based pulmonary rehabilitation. Methods: Prospective economic analyses were undertaken from a societal perspective alongside a randomized controlled equivalence trial in which adults with stable chronic respiratory disease undertook an 8-week outpatient center-based program or telerehabilitation. Clinical assessment for effectiveness (Chronic Respiratory Disease Questionnaire dyspnea domain score) was undertaken at baseline, after pulmonary rehabilitation, and at 12-month follow-up. Individual-level administrative and self-report healthcare cost data were collected over 12 months after the program (Australian dollars, 2020). Results: There were no between-group differences for effectiveness (Chronic Respiratory Disease Questionnaire dyspnea domain mean difference, −0.2 [standard error, 1.0]; P = 0.61) or total costs ($565 [5,452]; P = 0.92) over 12 months. On the cost-effectiveness plane, 97.4% of estimates fell between the equivalence margins for effectiveness. Application of a range of values for cost margin demonstrated a 95% probability that telerehabilitation was equivalent to center-based pulmonary rehabilitation when the threshold was $11,000. The results were robust to approach and sensitivity and subgroup analyses. The internal rate of return was 134% over 5 years. Program completion (regardless of model) was associated with a significant reduction in total costs in the following 12 months (β, −$17,960; 95% confidence interval, −29,967 to −5,952). Conclusions: This study supports delivery of telerehabilitation as a cost-effective alternative model of pulmonary rehabilitation for people with chronic respiratory disease. Clinical trial registered with the Australian and New Zealand Clinical Trials Register (ACTRN12616000360415). [ABSTRACT FROM AUTHOR]

Objectives: To identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics). Design: Qualitative study using a modified nominal group technique. Setting: Online semi‐structured interviews and workshops held in November 2022 and February 2023. Participants: Health workers involved in delivering virtual care in two metropolitan local health districts and one specialty statewide network, and people who had received care from these sites, were recruited using passive snowball sampling. Research and academic staff from a tertiary institution were also invited to participate. Main outcome measures: Priorities to support a translational research agenda for virtual care. Results: Twenty‐five individuals participated including 18 innovation deliverers, two innovation recipients and five implementation facilitators. Stakeholders identified several key priorities for developing virtual care models and for sustaining and scaling virtual care services. These included demonstrating the economic and societal value of virtual care, developing a common framework to support evaluation and comparison of virtual care services, ensuring virtual care services integrate acute and primary care, and defining which models of care are most appropriate for virtual care delivery. Conclusion: As the health system recalibrates with the return of in‐person care, there is a growing need to demonstrate the value of virtual care models to patients, the health system, and society at large. Demonstrating this value while also demonstrating improvements to health outcomes will future‐proof virtual care, enabling it to be used to address broader challenges of health care delivery. In addition, sustaining virtual care will depend on robust operational structures and workforce training and education. As services evolve, research and development priorities must be revisited to ensure that translational research aligns with stakeholder interests. [ABSTRACT FROM AUTHOR]

This case study evaluated the effects of a health package (HP) of a light intensity individualised exercise program and advice on anxiety management and nutrition, on the physical and mental health of people with or without COVID-19, who were quarantined in hotels used as Special Health Accommodation and admitted to the Royal Prince Alfred Virtual Hospital, Sydney during the COVID-19 pandemic. After initial screening and consenting, participants completed three surveys: Depression, Anxiety, Stress Scale; Brief Fatigue Inventory; and the European Quality of Life 5-Dimensions 5-Levels, and were provided with the HP for the duration of their quarantine. The three surveys and a participant reported experience measure were completed prior to discharge. The HP for people in quarantine demonstrated stability of health outcomes and reduction in fatigue. Most participants reported that the HP helped them cope with isolation. Provision of a HP during quarantine could be useful to support physical and mental health. What is known about the topic? Quarantine during the COVID-19 pandemic could negatively impact physical and mental health. What does this paper add? A health package of light intensity exercise, advice on anxiety management and nutritional information demonstrated maintenance of physical and mental health and reduced fatigue in people with and without mild COVID-19 in hotel quarantine. What are the implications for practitioners? Practitioners should consider providing a health package of exercise, anxiety management and nutritional information to help people in quarantine to cope with the physical and mental isolation. Adequate staffing is required to enable implementation. [ABSTRACT FROM AUTHOR]

This multi-centred, randomised controlled trial explored the effects of adding ongoing feedback to a 12-month unsupervised maintenance walking program, on daily physical activity (PA) in people with chronic obstructive pulmonary disease. Participants were randomised to either an intervention group (IG) or a usual care group (UCG). During the maintenance program, the IG received ongoing feedback (telephone calls, biofeedback provided via pedometer and progressive goal setting) and the UCG received no feedback. The SenseWear® Pro3 Armband was used to measure PA. Of the 86 participants {IG = 42, (mean [SD]: age 70 [7] years; FEV.sub.1 43 [16] % predicted); UCG = 44, (age 69 [9] years; FEV.sub.1 44 [15] % predicted)} included at baseline, 43 had sufficient data to be included in the final analysis. There were no between-group differences in any of the PA variables from baseline to completion of the program (all p > 0.05). Ongoing feedback was no more effective than no feedback in improving PA during a 12-month unsupervised walking program. Trial Registration: The trial was registered in the Australia and New Zealand Clinical Trials Registry (ACTRN12609000472279)., Author(s): Sally L. Wootton [sup.1] [sup.2] , Kylie Hill [sup.3] [sup.4] , Jennifer A. Alison [sup.1] [sup.5] , Li Whye Cindy Ng [sup.3] [sup.6] , Sue Jenkins [sup.3] [sup.4] [sup.7] [...]