Integrating remote patient monitoring into pulmonary rehabilitation: a feasibility RCT

Background : 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 program. Methods : This was a parallel-group, single-centre, cluster-randomized clinical trial embedded within a quality improvement initiative. Patients were allocated to Standard-PR (16 PR sessions delivered over six or eight 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. Results : Seventy-eight of 83 eligible patients approached were enrolled (94% recruitment rate; 55% male; mean age=68.4 (11) years; mean FEV 1 % predicted=59.1 (22.7). 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. One hundred percent 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. Conclusion : Integrating DRPM into PR was feasible based on pre-specified benchmarks, but substantially increased provider workload, underscoring the need for workflow optimization before initiating a larger trial.