New models of pulmonary rehabilitation for people with chronic lung disease
Pulmonary rehabilitation programs improve quality of life and reduced hospitalisation for people with chronic lung disease; however less than 10% of those who would benefit ever undertake a program. The challenges of regular travel to the rehabilitation centre are a major barrier for people who experience distressing breathlessness on exertion. At Alfred ARCH Professor Anne Holland leads a research program that develops and tests new models of pulmonary rehabilitation to improve access to care, including home-based rehabilitation and tele-rehabilitation.
HomeBase: A Novel Home-based Pulmonary Rehabilitation Program
The HomeBase clinical trial, conducted at Alfred Health and Austin Health and funded by NHMRC, demonstrated that a novel method of delivering pulmonary rehabilitation directly into the home was equally effective as a traditional centre-based program with similar costs and much higher completion rates. Importantly, those who completed pulmonary rehabilitation were 56% less likely to be hospitalised in the following 12 months. This study, published in Thorax in 2017, was nominated by the American College of Physicians as one of the most influential publications in respiratory medicine for that year, due to its potential to change practice globally. Alfred Health has adopted the HomeBase model into standard clinical care and other sites around Australia are also adopting this model.
What does HomeBase mean for patients?
Play the video to hear patients talk about their experiences of HomeBase
How do you deliver HomeBase?
- Holland AE, Mahal A, Hill CJ, Lee AL, Burge AT, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahham A, Gillies R, McDonald CF. Home-based rehabilitation for chronic obstructive pulmonary disease using minimal resources: a randomised, controlled equivalence trial. Thorax 2017;72:57-65.
- Cox NS, Oliveria CC, Lahham A, Holland AE. Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge and beliefs about consequences: a systematic review using the Theoretical Domains Framework. Journal of Physiotherapy 2017, 63 (2): 84–93
- Lahham A, McDonald CF, Mahal A, Lee AL, Hill CJ, Burge AT Cox NS, Moore R Nicolson C, O'Halloran P, Gillies R, Holland AE. Home-based pulmonary rehabilitation for people with COPD: a qualitative study reporting the patient perspective. Chronic Respiratory Disease, 2018; 15(2) 123-130. doi: 10.1177/1479972317729050.
- Lahham A, McDonald CF, Mahal A, Lee AL, Hil CJ, Burge AT, Cox NS, Moore R, Nicolson C, O’Halloran P, Gillies R, Holland AE. Acceptability and validity of a home exercise diary used in home-based pulmonary rehabilitation: a secondary analysis of a randomised controlled trial. Clinical Respiratory Journal, 2018; 12(6): 2057-64. doi: 10.1111/crj.12773.
- Lahham A, McDonald CF, Mahal A, Lee AML, Hill CJ, Burge AT, Cox NS, Moore R, Nicolson C, O’Halloran P, Gillies R, Holland AE. Participation in physical activity during center and home-based pulmonary rehabilitation for people with COPD: a secondary analysis of a randomized controlled trial. Journal of Cardiopulmonary Rehabilitation and Prevention, 2019; 39(2) E1-E4.