Comparing the Effectiveness of Home-Based Pulmonary Rehabilitation and Health Coaching to Usual Care for Patients With Fibrotic Lung Disease

Project Summary

This study compares the effectiveness of a home-based, technology-delivered pulmonary rehabilitation (PR) program with health coaching in adults with lung fibrosis who otherwise would receive no rehabilitation.

Who will this research inform?

Over 200,000 people in the United States live with lung fibrosis, but the majority do not receive pulmonary rehabilitation that can improve quality of life through better exercise tolerance and decreased shortness of breath. Results of this study will inform adults with lung fibrosis, their caregivers, clinicians and healthcare decision makers if a home-based PR program with health coaching by telephone offers improved quality of life and physical well-being over no PR, which is currently the experience of 60% of individuals with lung fibrosis who do not access specialized facilities.

What is the research team doing?

DesignRandomized wait-list controlled trialPopulation460 adults at least 18 years old with a diagnosis of fibrotic interstitial lung disease defined as at least 10% reticular or honeycomb changes on CT with clinically significant shortness of breath as measured by a score on the modified Medical Research Council (mMRC) scale of greater than 1.Interventions/ComparatorsHome-based PR with graded exercises and telemonitoring with weekly health coaching by phone for 12 weeksAttention waitlist control with no formal PR or coaching that allows participants to start home-based PR intervention plus coaching after 12 weeks upon requestPrimary OutcomesParticipant-reported respiratory-related quality of life (K-BILD) at 12 weeksPhysical activity (daily steps measured by actigraphy) at 12 weeks Secondary OutcomesShortness of breath (mMRC), self-management ability and healthcare utilization at twelve weeksKBILD changes at 6 months versus 3 months within the home PR group Patient and Community EngagementAdults with lung fibrosis, their caregivers, primary care doctors, administrators who make decisions about using the program and nonprofit and advocacy organizations for lung fibrosis are working with researchers on this study.