Virtual pulmonary rehabilitation in Canada: A national survey of programs during the COVID-19 pandemic

Pandemic related restrictions resulted in a shift from in-person care to virtual care in pulmonary rehabilitation (PR) programs across Canada. The extent and effects of this transformation are understudied. This study aimed to characterize virtual pulmonary rehabilitation (VPR) in Canada and summarize implementation changes since the pandemic. A national, cross-sectional, self-administered electronic survey was conducted between September and December 2023. Programs were identified through the public domain and national and provincial respiratory associations. A total of 184 PR program representatives were contacted: 114 were eligible to participate in the survey; of which 70 individuals representing 65 unique programs responded to the survey. A total of 71% of programs reported offering virtual care for PR assessment and/or treatment. More than 75% of programs used a hybrid approach for PR (eg, a combination of virtual and in-person care). Few programs used virtual care for pre/post assessments of exercise capacity and functional strength. Considerations for VPR included: assessing patient eligibility, emergency planning, implementation barriers and key resources. In the future, 69% of programs anticipated offering VPR, primarily using hybrid models of care. This survey provides insight into virtual care used by programs across Canada during the pandemic, highlighting considerations and plans for PR delivery in the future.