A novel approach to tele-exercise for geographically dispersed Cystic Fibrosis patients
The Adult Cystic Fibrosis Centre at The Prince Charles Hospital (TPCH) cares for the most geographically dispersed Cystic Fibrosis (CF) population across Australia with patients living across Queensland, the Northern Territory and Northern New South Wales.
This geographic spread creates significant challenges in Metro North’s ability to provide the same services to regional patients compared to people from Southeast Queensland. To make the service more complicated CF patients are suspectable to cross-infection and have poor immunity so therapy should always be conducted without patient-to-patient contact.
For CF patients with mild to moderate symptoms exercise is integral part of keeping healthy. During the height of COVID-19 during 2020, patients were naturally hesitant to attend hospital outpatient appointments for exercise and free online guided options were limited. As such patients enquired about a virtual model of care and the Adult CF Centre responded by proposing the development of tele-based exercise classes enhancing accessibility for all CF patients.
The Adult CF Centre used Facebook to broadcast tele-exercise classes. It was chosen because of the extensive use of the platform by CF patients and it was a highly efficient way of providing the service compared to one-on-one 30 minutes sessions. The Facebook group was voluntary, private and only accessible to those who were provided the link. No conservations occurred in the chat function to maintain patient privacy and data security
Considerations for clinicians about the service included that it needed to fit around other clinic times. Also, that it would need to be provided on a consistent basis to encourage engagement and adoption. Finally, it was also important the service wasn’t seen to replace telehealth but that it another way for patients to engage with clinicians and to improve health. To gain a consumer perspective on the service, patients who attended clinics were also asked for ideas about what would be engaging for them. This information was collated and formed a key part in the creation and evolution of the virtual exercise sessions.
Facilitated by a multi-disciplinary team, the tele-exercise service began operating every Thursday at 3pm from August 2020. To promote equity, the videos were also played on screens in patient rooms as inpatients may miss their exercise sessions for unavoidable reasons or other procedures. This has resulted in a tailored CF exercise program of 22 weeks. On average each of the videos have been viewed between 288 times by 112 people in the closed group = 35% with 69% of patients watching greater than 90% of each video. Feedback was obtained on a weekly basis from patients who had participated in the workouts and reviewed and implemented continuously resulting in a highly engaging service with great patient satisfaction.
‘The physio workouts have been great; I always knew I should exercise to help manage my CF but couldn’t work up the motivation and going to gyms made me nervous because of the risk of catching something. I tune in each week and it’s so easy to follow along and its great doing exercise that is specifically targeted to someone with CF! It’s fun and nice to see the staff members all working together and getting involved’ CF patient.