Who Enrolls After Referral to Virtual Pulmonary Rehabilitation? A Descriptive Comparison.

Background: Multidisciplinary management of chronic obstructive pulmonary disease (COPD) that combines pharmacotherapy, patient education, and pulmonary rehabilitation (PR) is recommended to optimize outcomes. Virtual pulmonary rehabilitation (VPR) offers a novel approach to expanding access to care by addressing geographic barriers. Methods: We conducted a retrospective cohort study involving patients with COPD who were referred to a VPR program from the pulmonary clinic of a single academic center. Demographic information was collected. The Social Vulnerability Index (SVI) was determined and the mean distance to the nearest in-person PR program. The primary objective was to describe the characteristics of patients referred to VPR who enrolled in the program compared with those who did not. The secondary objectives were to understand reasons patients choose not to enroll in VPR and to evaluate changes in clinical outcomes before and after participation in the program, with comparisons across SVI. Results: A total of 278 patients were referred, of whom 63 (22.7%) either completed or were actively participating in the program. Of the patients referred, 23 (8.3%) were ineligible, and another 45 (16.2%) declined enrollment. The average age of enrolled patients was 76.7 (8.4) years, and most patients were female (N=38, 60.3%). The average SVI was 0.53 (medium social vulnerability). The average distance to an in-person PR center was 12.6 miles. There were no significant differences in SVI, distance to PR center, language, or race between enrolled and nonenrolled patients. Conclusion: VPR may serve as an effective, accessible option for patients with COPD to improve functional and patient-centered outcomes. However, despite mitigating geographic barriers through VPR, obstacles to expanding PR program enrollment persist.