Nonadherence in Home-Based Pulmonary Rehabilitation Program for COPD Patients

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2020 Jan 31

PMID 31998425

Citations 11

Authors

Yi Li

Hongyu Qian

Kewei Yu

Ying Huang

Affiliations

Soon will be listed here.

Abstract

Background: The pulmonary rehabilitation (PR) is beneficial for COPD patients. Due to the poor rate of adherence, we evaluate the factors which will predict the nonadherence of PR.

Method: We analyzed the data from a retrospective study of COPD patients who were enrolled to attend the PR program. Patients were classified as the adherence group and the nonadherence group according to completion of over 50% sessions during the 8-week PR program. Demographic characteristics, 6-minute walking distance (6MWD), COPD assessment test (CAT), modified Medical Research Council scale (mMRC), and emotional function were compared between two groups. Univariate and multivariable analyses were performed to determine the factors of poor adherence of PR.

Results: Among 418 patients, 170 patients (40.7%) who completed less than 50% sessions of the PR program were categorized as "nonadherence." Compared to completers, "nonadherence" patients had more cigarette consumption, higher emotional score, less 6MWD, more exacerbation, using nebulizer frequently, and higher rate of smoking at enrollment. On multivariate analysis, more exacerbation frequency (odds ratio (OR) = 1.434, 95% confidence interval (CI): 1.191∼1.796, =0.046) and smoking at enrollment (OR = 3.349, 95% CI: 1.194∼6.302, =0.012) were predict factors associated with nonadherence of PR.

Conclusion: COPD patients with frequent exacerbation and smoking currently were more likely to be nonadherence during PR.

Citing Articles

Factors influencing adherence to home based pulmonary rehabilitation programme by high risk patients awaiting lung surgery: mixed methods study.

Yang X, Tang W, Xu L, Chen A, Zeng F BMJ Open. 2025; 14(12):e082933.

PMID: 39806650 PMC: 11683951. DOI: 10.1136/bmjopen-2023-082933.

Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases.

Chung C, Kim A, Kim D, Kwon H, Lee S, Jang I Sci Rep. 2024; 14(1):3018.

PMID: 38321153 PMC: 10847123. DOI: 10.1038/s41598-024-53583-2.

Clinical Efficacy of Mobile App-Based, Self-Directed Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis.

Chung C, Lee J, Lee S, Jo M JMIR Mhealth Uhealth. 2024; 12:e41753.

PMID: 38179689 PMC: 10786334. DOI: 10.2196/41753.

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study.

Sami R, Salehi K, Hashemi M, Haghighat S, Atashi V BMJ Open. 2023; 13(10):e073972.

PMID: 37802628 PMC: 10565240. DOI: 10.1136/bmjopen-2023-073972.

Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review.

de Oliveira T, Pereira A, Costa G, de Souza Mendes L, de Almeida L, Velloso M Front Rehabil Sci. 2022; 3:780736.

PMID: 36188941 PMC: 9397727. DOI: 10.3389/fresc.2022.780736.

References

Oates G, Hamby B, Stepanikova I, Knight S, Bhatt S, Hitchcock J . Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease. COPD. 2017; 14(6):610-617. PMC: 5830088. DOI: 10.1080/15412555.2017.1379070. View

Gupta N, Pinto L, Morogan A, Bourbeau J . The COPD assessment test: a systematic review. Eur Respir J. 2014; 44(4):873-84. DOI: 10.1183/09031936.00025214. View

Vogelmeier C, Criner G, Martinez F, Anzueto A, Barnes P, Bourbeau J . Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary. Eur Respir J. 2017; 49(3). DOI: 10.1183/13993003.00214-2017. View

Gaalema D, Cutler A, Higgins S, Ades P . Smoking and cardiac rehabilitation participation: Associations with referral, attendance and adherence. Prev Med. 2015; 80:67-74. PMC: 4592377. DOI: 10.1016/j.ypmed.2015.04.009. View

ODonnell D, Travers J, WEBB K, He Z, Lam Y, Hamilton A . Reliability of ventilatory parameters during cycle ergometry in multicentre trials in COPD. Eur Respir J. 2009; 34(4):866-74. DOI: 10.1183/09031936.00168708. View

Julian L . Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2012; 63 Suppl 11:S467-72. PMC: 3879951. DOI: 10.1002/acr.20561. View

Mahler D, Wells C . Evaluation of clinical methods for rating dyspnea. Chest. 1988; 93(3):580-6. DOI: 10.1378/chest.93.3.580. View

Wilbur J, Chandler P, Miller A . Measuring adherence to a women's walking program. West J Nurs Res. 2001; 23(1):8-24; discussion 24-32. DOI: 10.1177/01939450122044934. View

Degens H, Gayan-Ramirez G, van Hees H . Smoking-induced skeletal muscle dysfunction: from evidence to mechanisms. Am J Respir Crit Care Med. 2015; 191(6):620-5. DOI: 10.1164/rccm.201410-1830PP. View

10.

Lacasse Y, Maltais F, Goldstein R . Smoking cessation in pulmonary rehabilitation: goal or prerequisite?. J Cardiopulm Rehabil. 2002; 22(3):148-53. DOI: 10.1097/00008483-200205000-00004. View

11.

Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S . Cause-specific mortality for 240 causes in China during 1990-2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 387(10015):251-72. DOI: 10.1016/S0140-6736(15)00551-6. View

12.

Alison J, McKeough Z, Johnston K, McNamara R, Spencer L, Jenkins S . Australian and New Zealand Pulmonary Rehabilitation Guidelines. Respirology. 2017; 22(4):800-819. DOI: 10.1111/resp.13025. View

13.

Liu S, Zhou Y, Liu S, Chen X, Zou W, Zhao D . Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease: results from a cross-sectional study in China. Thorax. 2016; 72(9):788-795. PMC: 5738534. DOI: 10.1136/thoraxjnl-2016-208910. View

14.

Jones S, Green S, Clark A, Dickson M, Nolan A, Moloney C . Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence. Thorax. 2013; 69(2):181-2. DOI: 10.1136/thoraxjnl-2013-204227. View

15.

. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166(1):111-7. DOI: 10.1164/ajrccm.166.1.at1102. View

16.

Selzler A, Simmonds L, Rodgers W, Wong E, Stickland M . Pulmonary rehabilitation in chronic obstructive pulmonary disease: predictors of program completion and success. COPD. 2012; 9(5):538-45. DOI: 10.3109/15412555.2012.705365. View

17.

Monjazebi F, Dalvandi A, Ebadi A, Khankeh H, Rahgozar M, Richter J . Functional Status Assessment of COPD Based on Ability to Perform Daily Living Activities: A Systematic Review of Paper and Pencil Instruments. Glob J Health Sci. 2015; 8(3):210-23. PMC: 4803967. DOI: 10.5539/gjhs.v8n3p210. View

18.

Cassidy S, Turnbull S, Gardani M, Kirkwood K . Attendance at pulmonary rehabilitation classes: an exploration of demographic, physiological and psychological factors that predict completion of treatment. Chron Respir Dis. 2014; 11(2):95-102. DOI: 10.1177/1479972314527469. View

19.

Fischer M, Scharloo M, Abbink J, van t Hul A, Van Ranst D, Rudolphus A . Drop-out and attendance in pulmonary rehabilitation: the role of clinical and psychosocial variables. Respir Med. 2009; 103(10):1564-71. DOI: 10.1016/j.rmed.2008.11.020. View

20.

Shea S, Misra D, Ehrlich M, Field L, FRANCIS C . Correlates of nonadherence to hypertension treatment in an inner-city minority population. Am J Public Health. 1992; 82(12):1607-12. PMC: 1694541. DOI: 10.2105/ajph.82.12.1607. View