RT Journal Article SR Electronic T1 Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 220076 DO 10.1183/16000617.0076-2022 VO 31 IS 165 A1 Md. Nazim Uzzaman A1 Dhiraj Agarwal A1 Soo Chin Chan A1 Julia Patrick Engkasan A1 G.M. Monsur Habib A1 Nik Sherina Hanafi A1 Tracy Jackson A1 Paul Jebaraj A1 Ee Ming Khoo A1 Fatim Tahirah Mirza A1 Hilary Pinnock A1 Ranita Hisham Shunmugam A1 Roberto A. Rabinovich YR 2022 UL http://err.ersjournals.com/content/31/165/220076.abstract 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