Nonadherence in Home-Based Pulmonary Rehabilitation Program for COPD Patients

Area of Science:

• Pulmonary Medicine
• Respiratory Care

Background:

• Pulmonary rehabilitation (PR) offers significant benefits for patients with Chronic Obstructive Pulmonary Disease (COPD).
• Poor adherence rates remain a significant challenge in maximizing the effectiveness of PR programs.

Purpose of the Study:

• To identify predictive factors associated with nonadherence to PR in COPD patients.
• To understand characteristics differentiating adherent from nonadherent individuals in PR programs.

Main Methods:

• Retrospective analysis of 418 COPD patients undergoing an 8-week PR program.
• Patients classified as adherent (≥50% sessions completed) or nonadherent (<50% sessions completed).
• Comparison of demographic data, 6-minute walking distance (6MWD), COPD Assessment Test (CAT), mMRC, and emotional function; multivariate analysis performed.

Main Results:

• 40.7% of patients were categorized as nonadherent.
• Nonadherent patients exhibited higher cigarette consumption, poorer 6MWD, more frequent exacerbations, and higher emotional scores.
• Multivariate analysis identified frequent exacerbations (OR=1.434) and current smoking at enrollment (OR=3.349) as significant predictors of PR nonadherence.

Conclusions:

• COPD patients experiencing frequent exacerbations are more likely to be nonadherent to PR.
• Current smokers at the time of enrollment are significantly more prone to nonadherence in PR programs.