Effectiveness of a hybrid home-based pulmonary rehabilitation programme after hospitalisation for COPD-exacerbations: preliminary results.

<bold>Background:</bold> Hybrid pulmonary rehabilitation (PR), combining home face-to-face and telerehabilitation sessions seem worth developing. We aimed to assess the feasibility and effectiveness of an 8-week hybrid home-based PR programme in patients with chronic obstructive pulmonary disease (COPD) discharged from an exacerbation-related hospitalisation. <bold>Methods:</bold> PR consisted of 4 supervised face-to-face home sessions and 4 remotely supervised sessions (telerehabilitation), with one session per week during 8 weeks. Education, self-management strategies and physical training were implemented at home. Dyspnea (mMRC, Dyspnea-12 questionnaire), fatigue (FAS), quality of life (CAT), anxiety and depressive symptoms (HAD) and exercise tolerance (6-min stepper test) were assessed. <bold>Results:</bold> 303 patients were included: 48 (16%) refused PR, 79 (26%) refused hybrid PR (no internet, not confident in using remote tool, hearing and sight problems) but accepted 8 face-to-face home sessions (group 2) and 176 (58%) patients performed hybrid PR (group 1). At baseline, group 1 was younger (64vs.70 years) and had a lower mMRC (3.0vs.3.3 points) than group 2. All the outcomes were improved in group 1 (p<0.01), while group 2 did not improve fatigue (p=0.098), anxiety (p=0.512) and exercise tolerance (p=0.063). With the exception of anxiety symptoms (p=0.023), outcomes evolution was similar between groups. <bold>Conclusion:</bold> These preliminary results suggest that this hybrid PR is: i) feasible and effective at short-term for patients discharged from an exacerbation-related hospitalisation; ii) but not suitable for all patients (42% of refusal).