Evaluation of research in pulmonary rehabilitation programs in Asia for people with chronic respiratory diseases: a scoping review

Abstract

The incidence of people with chronic respiratory diseases (CRDs) in Asia is growing. While pulmonary rehabilitation (PR) programs in western countries have been extensively evaluated in the literature, little is known about how PR programs are currently implemented in Asia. The main objective of this project was to investigate the PR programs evaluated by researchers in the Asia region according to the structure, content, delivery and outcomes of PR programs in the Asia region. Secondary objectives were to evaluate the overall completion rates across PR programs and if these programs adhered to recommendations as stated in the 2021 American Thoracic Society (ATS) PR Workshop Report (Holland et al., 2021). To meet the objectives of the project, a scoping review was conducted based on the PRISMA scoping review guidelines. Five databases including CINAHL, Medline, Embase, Web of Science and Health and Medical Collection were searched from inception until 22nd July 2022. Data was extracted and analysed as per the following categories: study characteristics (country, study design, population, and sample size); intervention (type and dosage); and outcomes evaluated (outcome measurement tools). A total of 3804 studies were identified, of which 127 studies were included for final inclusion. Our review found that majority of studies (72%) focused on evaluating alternative interventions such as Tai Chi and Qigong. Forty-five studies (35%) did not include endurance and/or resistance training. Exercise capacity (74%) and quality of life (QOL) measures (72%) were the most frequent outcomes used to evaluate the efficacy of the program. Only 28% of the included studies consistent with the interventions outlined in the 2021 ATS PR Workshop Report. In summary, majority of programs evaluated in Asia included a diverse range of interventions. However, only a small proportion of studies included a program that was in-line with the 2021 ATS PR Workshop Report. While interventions were different, it appears that main outcomes used in these studies appeared to be in-line with the ATS recommendations and recently published core outcome set for PR (Souto-Miranda et al., 2023). The findings from this scoping review can guide future studies to evaluate if improvements in exercise tolerance and QOL measures of PR programs that include alternative interventions are just as effective as globally recognised PR programs in improving outcomes for people with CRDs.

Date of Thesis submission	2023
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Clarice Tang (Supervisor), Felicity Blackstock (Supervisor) & Sheree Smith (Supervisor)