Breath of fresh care for rural COPD patients
(Edmonton) A researcher in the Faculty of Medicine & Dentistry and his colleagues in the Centre for Lung Health are on a mission to keep patients with chronic obstructive pulmonary disease out of hospital. No easy task, given that COPD is one of the top causes of hospitalization in the country and a major burden on the health-care system.
Michael Stickland, in the faculty’s Division of Pulmonary Medicine, and colleague G. Fred MacDonald know that rehabilitation is vital to improving patients’ quality of life and keeping them out of hospital. That is tough, though, when there are limited respiratory services north of Edmonton and most are clustered in urban centres across the province.
“The lung function [of patients in rural communities] was similar to those in urban centres, but the rural groups had worse quality of life and worse exercise tolerance,” said Stickland. “So there’s some evidence to show that these patients are not managing as well in rural regions as they are in Edmonton and [other] urban centres.”
Telehealth: Reaching out to rural patients
MacDonald came up with the idea of using telehealth technology to reach out to patients in these communities.
“We beam the education sessions to outlying rural regions and conduct pulmonary rehab in towns like Camrose and Grande Prairie that normally wouldn’t have access,” said Stickland. Thirteen rural sites jumped on board when the telehealth rehab program was launched from the Centre for Lung Health, operated by Covenant Health at Edmonton’s General Hospital.
Now, numerous patients in northern Alberta communities gather around televisions twice a week to learn more about the disease that has changed their life—and could take their life. They also do exercises at their home sites to help improve their quality of life, and they are able to get consultations with pulmonologists through telehealth.
This marks the first time that telehealth has been used in pulmonary medicine in Alberta.
A short time after the program was launched, Stickland studied its effectiveness. The results were positive: patients’ quality of life had improved and they were more able to handle exercise after two months in the program. This research was published in the Canadian Respiratory Journal.
“This is a nice partnership between the U of A and Covenant Health,” said Stickland, “taking good clinical practice and a good clinical idea, translating that to rural areas and showing it’s effective through research.”
The Centre for Lung Health, which sees about 400 patients a year, is now looking at ideas such as podcasts and DVDs that people can use for the education portion of their rehabilitation.
“We’re interested in investing in something that’s home-based because one of the top reasons people don’t come to rehab is transportation,” said Stickland.