Home-based pulmonary rehabilitation and health coaching in fibrotic interstitial lung disease: a perspective on current evidence and future directions.

Introduction: The fibrotic interstitial lung diseases ;(f-ILD) are often progressive and debilitating lung diseases with significant symptom burden and impaired quality of life. Pulmonary rehabilitation (PR) has demonstrated improvements in dyspnea, physical function, and respiratory-related quality of life (RR-QoL) in patients with -f-ILD but had limited uptake and completion in real-world settings.

Areas covered: A literature review was completed on the impact and limitations of traditional PR in f-ILD, with additional perspective on the use of home-based approaches and implementation of health coaching. Barriers to traditional center-based PR programs include patient and systems-based factors such as unawareness of benefit, emotional or psychological distress, and limited access. Home-based PR may address these limitations by removing travel barriers, increasing access with remote supervision and monitoring, and promoting social support by connecting care with familiar settings. Studies involving home-based PR in ILD have shown promise with improving functional and quality of life outcomes and high compliance rates. Health coaching is a collaborative paradigm for fostering behavior change and has demonstrated positive impact in the management of chronic diseases.

Expert opinion: A combination of health coaching with home-based PR may address ongoing challenges of PR uptake and compliance as well as expand PR as a holistic and comprehensive intervention.