Telerehabilitation in chronic respiratory disease

Pulmonary rehabilitation (PR) is an evidence-based and cost-effective treatment to improve exercise capacity, quality of life and symptom management in patients with chronic respiratory disease. However, it is significantly underutilised worldwide. Telerehabilitation has been recommended as a potential solution to address barriers to traditional PR and can be delivered via telephone, videoconferencing and web/app programmes, and may incorporate remote monitoring of physiological parameters. Although the use of telehealth drastically increased during the coronavirus disease 2019 pandemic and evidence suggests that telerehabilitation may achieve similar benefits to centre-based PR, the certainty of the evidence is limited. Additionally, there are a number of patient, health professional and system-level barriers that may hinder implementation in clinical services. To facilitate adoption of telerehabilitation in clinical services, high-quality clinical trials evaluating the effectiveness, safety and cost-effectiveness compared with centre-based PR programmes are needed, as well as the development of evidence-based clinical guidelines for implementation and quality assurance.