Participating in digital respiratory post-rehabilitation programs: understanding the obstacles
Nearly half of patients still refuse to participate in a digitally supported remote maintenance pulmonarydigital caregibver rehabilitation programme (M-PRP), despite the known benefits of these measures. A recent study highlights the main barriers to their participation and which patient profiles are most affected.
Predictors of and reasons for refusal to participate in a digitally supported remote maintenance pulmonary rehabilitation programme
Summary
Respiratory rehabilitation is essential for improving the health and quality of life of people with COPD, but its effects often fade over time. To extend its benefits, remote maintenance programmes have been developed, in particular via digital tools. However, many patients refuse to participate, often because of barriers related to age, social situation or digital literacy, calling into question whether such programmes can be widely used. The study therefore aimed to identify the reasons for refusal with a view to improving access to these programmes and/or adapting care pathways.
Main lessons learned
- Despite their benefits and effectiveness, these types of programmes cannot be implemented for all patients.
- Around half of patients agree to participate in a maintenance pulmonary rehabilitation programme incorporating a digital solution, while the other half decline this proposal.
- Refusals are more common in patients with severe respiratory disease, low digital literacy or a personality profile marked by neuroticism.
- The main reasons given for refusal are the programme’s perceived limits (47%), the desire to maintain rehabilitation independently (45%) and a lack of computer equipment (29%).
- Training on digital tools can drive greater access.
- Alternatives to digital solution-based follow-up programmes should be offered to meet the needs of as many patients as possible and ensure that the benefits of long-term rehabilitation programmes are maintained.
Key takeaways
Adherence to programmes for the maintenance of post-respiratory rehabilitation does not depend solely on technology: it is also linked to personality, clinical condition and the relationship to digital technology. Adapting tools, better supporting patients and understanding their individual barriers are key levers to strengthen the effectiveness of digital approaches to respiratory health.
Methodology
Patients who completed a respiratory rehabilitation programme were contacted to participate in a 12-month digital remote follow-up programme (Maintenance Pulmonary Rehabilitation Programme, M-PRP).
The researchers collected their clinical and socio-demographic characteristics and had them complete 11 standardised questionnaires, including:
- digital literacy (Mobile Device Proficiency Questionnaire-16, MDPQ-16);
- personality traits (Big Five Inventory-10, BFI-10);
- as well as the reasons for refusing to participate.
The objective was to identify the predictive factors (clinical, psychological or technological) and the declared reasons for non-adherence to the programme.