Sept. 10, 2024
Pulmonary, Critical Care Medicine and Sleep Medicine at Mayo Clinic in Rochester, Minnesota, is launching a program for home rehabilitation for individuals living with chronic obstructive pulmonary disease (COPD) after hospital admission. This is a long-awaited program that is innovative in the country as a solution that includes systematic rehabilitation after hospital admission.
Rehabilitation for individuals with COPD is considered one of the cornerstones of therapy, particularly after a hospitalization, given that it improves every outcome including quality of life, exercise capacity and survival. Unfortunately, less than 2% of people nationwide receive rehabilitation after a COPD-related hospital admission despite the strong scientific evidence favoring its use. Barriers such as transportation and accessibility, including rurality, transit time and frailty to leave the home have been top reasons for the lack of adherence to this effective therapy.
The idea of a home rehabilitation for COPD, instead of the conventional center-based rehabilitation, has been proposed for many years by scientific societies, but home programs for COPD rehabilitation are still not widely available.
The National Institutes of Health (NIH) funded the Mindful Breathing Laboratory at Mayo Clinic to create and test a feasible yet effective program of rehabilitation for individuals with COPD.
Mayo Clinic Mindful Breathing Laboratory
This lab studies how self-awareness, mindfulness, physical activity and self-management impact the health and lifestyle of people who live with chronic conditions.
The Mindful Breathing Laboratory developed and tested a home program that was found in peer review not only effective improving all domains of quality of life but also symptoms of depression-anxiety, daily physical activity, sleep and importantly the patient experience.
Due to the research success, Mayo Clinic leadership decided to pursue clinical implementation to make the program available to all patients.
The rehabilitation system uses simple technology that includes a dedicated cellphone, an oximeter and an activity monitor. The cellphone is easy to use and provides the ability to capture patients' symptoms, reported daily, physical activity, and provide simple, daily guided grounding exercises that were part of the successful research program.
A unique feature of this home rehabilitation program crafted from the NIH-funded research is the addition of health coaching. Every individual in this program connects through a video call to a health coach every week through the provided phone. The video calls have been tested in rural and metropolitan areas without problems.
The addition of health coaching in this program is highly innovative: It is the first program of its kind in which health coaches create conditions for a genuine engagement with patients to aim the rehabilitation program to fulfill the patient's values and goals. Personalization is at the core of the very culture of Mayo Clinic: "the needs of the patient come first."
Another innovative feature is that the program aims for a lifestyle behavioral change in daily life in the context of living with COPD and goes beyond exercise prescription and education. It follows the World Health Organization definition of rehabilitation: "A set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment."
The launch of this program will be directed first to individuals with COPD who are more in need: the ones after a hospital admission. The 12-week program is universally available and is billed through Medicare and Medicaid-approved codes.
Mayo Clinic plans to keep it growing quickly to offer it to every patient with COPD, not just in the posthospitalization period.
Mayo Clinic's passion for universal access to rehabilitation for all respiratory conditions does not stop. The division is now funded by the Patient-Centered Outcomes Research Institute (PCORI), with Teng Moua, M.D. – principal investigator, pulmonologist and critical care specialist at Mayo Clinic in Rochester, Minnesota — to test a home rehabilitation program for individuals living with pulmonary fibrosis.
The division also has funding by the NIH to test the home program for people with COPD in rural America, with Roberto P. Benzo, M.D., who is the principal investigator and a pulmonologist at Mayo Clinic in Rochester, Minnesota.
There is a strong sense of inclusivity in the vision for this home program to be able to improve health in all patients with respiratory conditions, as the World Health Organization definition of health is truly embraced: "It is a balance and not the absence of conditions."
For more information
Refer a patient to Mayo Clinic.