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What is the challenge your project is going to address and how does it connect to your chosen theme?

Patients with chronic lung diseases benefit greatly from supervised exercise programmes such as pulmonary rehabilitation. Unfortunately, physical activity levels are lost over time after completion of these programmes. Adherence to unsupervised exercise can be highly variable and is difficult to maintain.

Outpatient appointments are often difficult to access following completion of pulmonary rehabilitation. Having a digital platform where patients can access support from their rehabilitation professionals either with scheduled appointments or simply in an instant messaging form may help in maintaining focus. This may be very important following an infective exacerbation when any well formed exercise habits may be lost and the patient may not know how to become active again. From our experience, patients that complete pulmonary rehab have high trust in staff providing the intervention and would welcome the ability to access us to maintain focus on maintaining well formed exercise habits.

What does your project aim to achieve?

Objective

Providing a “bridge” to independent exercise following completion of pulmonary rehab with staff that patients have an existing therapeutic relationship with in the form of a virtual clinic using a secure digital platform.

Intended Benefits

Often, exercise maintenance programmes are “open ended” meaning there are no specific plans or incentives to promote independent exercise habits once contact with the service has ended. This may be due to an exacerbation for example.

Providing access via a virtual clinic to check with independent exercise progress, answer queries and provide exercise sessions to patients may assist in prolonging higher physical activity levels and other health enhancing behaviours such as reducing emergency healthcare utilisation.

How will this be measured?

Measurement of physical activity levels using accelerometry, symptom control and health related quality of life questionnaires at review including fitness testing using field based walk and strength tests

How will the project be delivered?

Relevant people and skills involved

My line manager, Helen Parrott is the trust AHP digital lead and has experience in creating a digital platform for patients with cystic fibrosis. I will seek support and guidance from our new Chief innovation and technology officer, Rishi Das-Gupta on digital platform options including risk, governance and procurement of hardware.

Funding will provide ability to purchase or develop a secure digital platform such as Zoom and assist in back filling our exercise practitioner for the duration of the project to undertake the role of developing the clinic with the support of myself.

I will require the support of any existing Q community members with expertise in virtual services or tailoring of digital platforms.

Effective use of resources

A band 4 exercise practitioner will be able to deliver a core of the virtual care where traditionally a physiotherapist might normally be tasked to do so.  The clinic may help with appropriate signposting to primary care.

What and how is your project going to share learning throughout?

A “warts and all” blog of the projects progress in real time may be an invaluable resource for the Q community shared with relevant interest groups and forums on the Q website. With the NHS long term plan, more services will be expected to have digital technologies support care delivery. The blog may help to prevent a “re-inventing of the wheel” as services and/or organisations often work in siloed ways. This will help others to save time and energy in avoiding any potential barriers or pitfalls through the experiences gained in this project.

Maintenance of physical activity and exercise following completion of pulmonary rehabilitation (PR) in chronic respiratory disease, particularly COPD is poor and not well understood. This project and its outcomes will be of interest to the respiratory community and will therefore be shared within our organisation as well as national and international conferences in the form of abstract and poster presentations.

How you can contribute

  • 1. Are there members with experience of digital services or platform development?
  • 2. Are there members with an interest in respiratory disease willing to support or collaborate?

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