Predictors of and reasons for refusal to participate in a digitally supported remote maintenance pulmonary...

Objective: The study aimed to assess the predictors and the reasons for refusal to participate in a digitally supported remote maintenance pulmonary rehabilitation programme (M-PRP). Methods: Patients contacted to integrate a 12-month M-PRP were assessed for clinical and sociodemographic characteristics and completed a series of 11 questionnaires including digital literacy (MDPQ-16), personality traits (BFI-10) and reasons for refusal. Results: Of the 136 patients included, 78 accepted the M-PRP and 58 refused (43%). The likelihood of refusal was associated with low forced expiratory volume in 1s (FEV₁), body mass index, neuroticism (BFI-10) and MDPQ-16. Main reasons for refusal were programme constraints (47%), intention to continue physical activity alone (45%), and lack of information technologies (IT) equipment (29%). Conclusion: Digital M-PRP rejection is a common problem. Disease severity and technology issues are main barriers. Particular attention should be paid to patients who state they intend to continue on their own, given conflicting literature data.