Home-Pulmonary Rehabilitation Programme for Patients with Chronic Respiratory Diseases in Malaysia: A Mixed Method Feasibility Study

Abstract Introduction Pulmonary rehabilitation (PR) could improve health outcomes for the increasing number of people with chronic respiratory diseases (CRDs), but programmes need to be adapted to low-resource settings and, in the context of a pandemic, to home-based delivery. Aim To assess the feasibility of delivering a home-PR programme for patients with CRDs in Malaysia. Methods We recruited patients with CRDs from two hospitals in Klang Valley, Malaysia to a Home-PR programme. Following Centre-based assessment, patients performed the exercises at home (five sessions/week for 8 weeks (total 40 sessions)). We monitored the patients via weekly telephone calls and asked about adherence to the programme. We measured functional exercise capacity (6-Minutes walking test (6MWT)) and Health-Related Quality-of-Life (HRQOL: COPD Assessment Test (CAT)) at baseline and post- PR at 9 weeks. We conducted semi-structured interviews with 12 purposively sampled participants to explore views and feedback on the Home-PR programme. Interviews were audio recorded, transcribed verbatim and analysed thematically. Results 30 patients participated; two withdrew due to hospitalisation. Although 28 (93%) adhered to the full programme, only 11 (37%) attended the post- PR assessment because COVID-19 movement restrictions in Malaysia at that time prevented attendance at the centre. Four themes emerged from the qualitative analysis: (1) involvement of family and caregivers, (2) barriers to Home-PR programme, (3) interactions with peers and healthcare professionals, and (4) programme enhancement. Conclusion Despite the COVID-19 pandemic, the Home-PR programme proved feasible to be delivered remotely, although Centre-based post-PR assessments were not possible. Family involvement played an important role in the Home-PR programme. The delivery of this programme can be further improved to maximise the benefit obtained.