Adherence to Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Background: Pulmonary rehabilitation (PR) allows for the treatment of patients with chronic obstructive pulmonary disease (COPD) as an intervention strategy that improves functional capacity, dyspnea, and health-related quality of life. However, adherence to such programs might be improved. This study aimed to describe the differences in sociodemographic and clinical variables, functional capacity, and health-related quality of life in patients diagnosed with COPD adherent and non-adherent to pulmonary rehabilitation at a clinic in Cali, Colombia. Methods: This study followed a descriptive cross-sectional model with 150 patients diagnosed with COPD. Adherence was classified by taking into account the number of sessions completed: low (<35%), moderate (35–85%), and high (>85%). Sociodemographic, clinical, functional capacity, and health-related quality of life variables were considered. Results: Adherence to the PR was rated as high in 57.3% of patients. Variables such as sex, health system affiliation, height, functional capacity, resting SaO2, and health-related quality of life presented significant differences (p-value ≤ 0.05). The main causes of non-adherence to the program were medical recommendations that prevented continuing in the program due to clinical and safety issues and economic issues that prevented reaching the rehabilitation site, as it was unaffordable. Conclusions: It can be concluded that adherence to pulmonary rehabilitation was rated as high in 57.3% of patients. The high adherence to the PR program occurred in male patients with a capacity to pay the Colombian health system (contributory regime).

Impact of telephone follow-up on COPD outcomes in pulmonary rehabilitation patients: A randomized clinical trial

“…The studies that include telephone support during PR are generally for home PR programs or investigate treatment adherence several months after completion. While this study reports similar results regarding adherence to the PR, 31 the outcomes from other studies utilizing telephonic support are somewhat contradictory. There were positive impacts in one of the studies: less dyspnea, more exercise tolerance, and improvement in HRQoL in those who received home PR with TFU (p <0.05) 32 ; the opposite was shown in the study by Hornikx et al, in which there were no significant differences in physical activity in patients who had telephone counselling to guide home physical exercise.…”

“…7 Additional tactics, like education, may prove helpful in maintaining the benefits of PR and ensuring compliance with health provider guidance. 8 Telephone follow-up (TFU) is a strategy that allows continuous communication with the patient beyond face-toface encounters and has demonstrated positive effects on adherence to PR treatment. 9-12 However, there is limited research studying the effects of including TFU as part of the PR treatment to improve adherence and outcomes.…”