A Staffordshire based NHS funded project has enabled patients with chronic lung conditions to continue their pulmonary rehabilitation without disruption, during the most recent national lockdown.
The project has seen more than 240 patients with chronic lung conditions use virtual reality headsets, to carry out supervised pulmonary rehabilitation exercises at home.
Patients with chronic lung conditions are at a greater risk of hospital admission during the winter, so this project was of the utmost importance for ensuring that the patients involved remained safe at home during the recent spike in Covid-19 hospitalisations. The project has allowed the vulnerable patients involved to remain safe at home, and engaged in their pulmonary rehabilitation programmes.
The majority of the patients who took part in the project have moderate to severe lung disease, and pulmonary rehabilitation has been shown to improve the health status of patients with such chronic lung conditions.
Consequently, when clinical services began coming to a halt, due to the Covid-19 pandemic, GPs in Staffordshire commissioned the digital pulmonary rehabilitation service in order to prevent an increased risk of hospital admission among patients with chronic lung conditions.
The Staffordshire based programme has been rolled out by Concept Health Technologies, a British start-up, and features an invention by an NHS GP, Dr Farhan Amin.
Dr Farhan Amin was concerned about the long waiting times that his patients faced for pulmonary rehabilitation. Consequently, he set out to develop a programme that could be delivered via a virtual reality headset, and ensure that participants could be monitored in real time from a remote location. After a successful pilot with an independent evaluation, GP practices in Staffordshire have been amongst the first in England to deploy this service at scale.
Patients are contacted quickly by the team at a remote monitoring centre if there is a problem, so patients can exercise with confidence knowing that they are being supervised. Any significant clinical issues are also flagged promptly to the patient’s GP by the team.
The programme has received extremely positive feedback from patients, with those who have taken part commenting that they appreciate the shorter waiting times for treatment, and the convenience of being able to complete their exercises at home. Patients have also reported that partaking in an exercise therapy programme during lockdown has helped them to cope better with the restrictions.
The patients involved in the project have already reported improvements in their conditions, better mobility, and improved energy levels and sleep. In addition, patients have found the exercises in virtual reality to be extremely engaging, and compliance levels have been high.
Staffordshire GPs are now evaluating whether the support provided by this service could also be suitable for patients with symptoms of Long Covid.
Dr. Mukesh Singh, a Staffordshire GP who supported the launch of this service, comments; “COPD is the third largest cause of death in UK and worldwide, and two thirds of COPD patients do get a flareup every year. Each flare up causes a significant and irreversible decline in lung function, increasing their risk of hospitalisation, worsening their quality of life, and sadly, sometimes causing early death”.
Dr. Mukesh Singh continues; “Early initiation of pulmonary rehabilitation reduces the risk of early deaths and that figure is quite staggering, it reduces death rates by 42%. I urge the patient to discuss the option of referral to pulmonary rehabilitation in virtual reality”.
Dr Ruth Chambers, Staffordshire STP’s Clinical Lead for its Technology Enabled Care Services programme, adds; “The twenty or so general practice teams who are referring patients to this fantastic new service cover a quarter of the North & Mid-Staffordshire population. The usual face to face services provided to the hundreds of thousands of other patients with this condition across the UK are not operating due to the current pandemic. It is too risky for patients who must shield at home to be out and about attending rehabilitation clinics”.
The service evaluation of the programme is currently conducted by research team lead by Dr Timothy Jung, Director of Creative AR & VR Hub at Manchester Metropolitan University, and he comments; "I am delighted to participate in this innovative healthcare VR project in Staffordshire and happy to contribute to evaluation of service redesign of Pulmonary Rehabilitation in Virtual Reality (PRinVR) which potentially have huge impact on existing health service delivery under the current Covid-19 pandemic situation in UK"