PT  - JOURNAL ARTICLE
AU  - Md. Nazim Uzzaman
AU  - Dhiraj Agarwal
AU  - Soo Chin Chan
AU  - Julia Patrick Engkasan
AU  - G.M. Monsur Habib
AU  - Nik Sherina Hanafi
AU  - Tracy Jackson
AU  - Paul Jebaraj
AU  - Ee Ming Khoo
AU  - Fatim Tahirah Mirza
AU  - Hilary Pinnock
AU  - Ranita Hisham Shunmugam
AU  - Roberto A. Rabinovich
TI  - Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis
AID  - 10.1183/16000617.0076-2022
DP  - 2022 Sep 30
TA  - European Respiratory Review
PG  - 220076
VI  - 31
IP  - 165
4099  - http://err.ersjournals.com/content/31/165/220076.short
4100  - http://err.ersjournals.com/content/31/165/220076.full
SO  - EUROPEAN RESPIRATORY REVIEW2022 Sep 30; 31
AB  - Introduction Despite proven effectiveness for people with chronic respiratory diseases, practical barriers to attending centre-based pulmonary rehabilitation (centre-PR) limit accessibility. We aimed to review the clinical effectiveness, components and completion rates of home-based pulmonary rehabilitation (home-PR) compared to centre-PR or usual care.Methods and analysis Using Cochrane methodology, we searched (January 1990 to August 2021) six electronic databases using a PICOS (population, intervention, comparison, outcome, study type) search strategy, assessed Cochrane risk of bias, performed meta-analysis and narrative synthesis to answer our objectives and used the Grading of Recommendations, Assessment, Development and Evaluations framework to rate certainty of evidence.Results We identified 16 studies (1800 COPD patients; 11 countries). The effects of home-PR on exercise capacity and/or health-related quality of life (HRQoL) were compared to either centre-PR (n=7) or usual care (n=8); one study used both comparators. Compared to usual care, home-PR significantly improved exercise capacity (standardised mean difference (SMD) 0.88, 95% CI 0.32–1.44; p=0.002) and HRQoL (SMD −0.62, 95% CI −0.88–−0.36; p<0.001). Compared to centre-PR, home-PR showed no significant difference in exercise capacity (SMD −0.10, 95% CI −0.25–0.05; p=0.21) or HRQoL (SMD 0.01, 95% CI −0.15–0.17; p=0.87).Conclusion Home-PR is as effective as centre-PR in improving functional exercise capacity and quality of life compared to usual care, and is an option to enable access to pulmonary rehabilitation.Home-based pulmonary rehabilitation is as effective as centre-based in improving exercise capacity and quality of life, and is an option for people with COPD whose access to pulmonary rehabilitation centres is difficult. https://bit.ly/39HkMm4