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Development and Validation of a Multivariable Exercise Adherence Prediction Model for Patients with COPD: A

Ellen Ricke1, Eric W Bakker2

  • 1Department of Social Psychology, University of Groningen, Groningen, the Netherlands.

International Journal of Chronic Obstructive Pulmonary Disease
|March 29, 2023
PubMed
Summary

This study developed a model to predict adherence to pulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD), identifying key predictors to personalize care and optimize healthcare resources.

Keywords:
chronic obstructive pulmonary diseasepulmonary rehabilitationself-managementsustainable healthcare

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Area of Science:

  • Pulmonary Medicine
  • Rehabilitation Science
  • Health Services Research

Background:

  • Pulmonary rehabilitation (PR) improves quality of life for COPD patients but faces challenges with adherence and cost.
  • Self-management is a potential solution, but non-adherence hinders its effectiveness.
  • Predicting adherence can help tailor support for COPD patients undergoing PR.

Purpose of the Study:

  • To develop and validate a predictive model for adherence to PR in patients with COPD.
  • To identify factors influencing adherence to optimize self-management strategies.
  • To enable personalized care and efficient resource allocation in PR programs.

Main Methods:

  • A prospective cohort study involved 196 COPD patients across 53 primary physiotherapy practices.
  • A multivariable logistic regression model was developed using backward selection.
  • Internal validation was performed using bootstrapping (n=500) with assessment of discrimination, calibration, and clinical utility.

Main Results:

  • The final model included four predictors: intention, depression, MRC-score, and alliance.
  • The optimism-corrected AUC was 0.79 (95% CI, 0.72-0.85), indicating good predictive performance.
  • Calibration plots and decision curve analysis demonstrated good calibration and clinical utility.

Conclusions:

  • The developed model shows potential for clinical use in predicting PR adherence in COPD patients.
  • This tool can facilitate patient-centered management, optimizing treatment frequency.
  • Implementing the model may improve healthcare capacity distribution and reduce healthcare pressure without compromising PR effectiveness.