The Reasons for Non-Adherence in Pulmonary Rehabilitation Programs

Candemir, İpek; Kaymaz, Dicle; Ergün, Pınar

doi:10.5152/ejp.2016.85547

Cited by 5 publications

(12 citation statements)

References 18 publications

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“…In conclusion, the findings shed light on multidisciplinary interventions and cardiac rehabilitation for local Asian cardiac patients. As is consistent with previous literature, there is an indication for greater referrals to cardiac rehabilitation [ 39 ], and wider publicity and education to both patients and clinical staff on benefits of cardiac rehabilitation [ 36 ]. Provision of cardiac rehabilitation training could also be provided to healthcare professionals at private clinics, and polyclinics to promote greater implementation of cardiac rehabilitation, and to increase the geographical coverage and accessibility of cardiac rehabilitation [ 19 ].…”

Section: Discussionsupporting

confidence: 87%

“…Another aspect of cardiac rehabilitation, which is related to non-adherence to the cardiac rehabilitation program, could be further investigated, in order to obtain information, which could be used to further refine and tailor the program to optimize adherence [ 35 ]. Future study could investigate the varied reasons that might account for non-adherence, e.g., individual or intrapersonal factors that might contribute to the patients’ inability to comprehend efficacy and contents of the cardiac rehabilitation program [ 36 ] or busy work schedules [ 37 ]. Such variables are important to consider, in tailoring a program to maximize patient motivation and adherence and could be explored in qualitative interviews with patients who dropped out of cardiac rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients

Choo

Chew

Lai

et al. 2018

IJERPH

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This study explored the effect of cardiac rehabilitation on quality of life, depression, and anxiety in Asian patients in Singapore. Out of the 194 patients who were recruited into the study, 139 patients (71.6%) completed both the pre- and post-cardiac rehabilitation questionnaires. Their ages ranged from 28 to 80 (M = 56.66, SD = 8.88), and 103 patients (74.1%) were males and 21 patients (15.1%) were females. As hypothesized, there was a statistically significant difference between the pre- and post-cardiac rehabilitation scores on the combined dependent variables, F (4, 135) = 34.84, p < 0.001; Wilks’ Lambda = 0.49; partial eta squared = 0.51. An inspection of the mean scores indicated that patients reported higher levels of physical and mental quality of life and lower levels of depression post-cardiac rehabilitation. The findings were discussed in regards to implications in cardiac rehabilitation in Singapore.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients

Choo

Chew

Lai

et al. 2018

IJERPH

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“…Similarly, a 2-year long study from Turkey showed the rate of drop-out as 22.3% in patients with chronic respiratory disorders. These patients had decreased exercise capacity and sensation of dyspnea (41). Similarly, in Turkey, the most common reasons for non-adherence of PR were found to be the inability of understanding the efficacy and contents of PR program, lack of motivation, and transportation problems (41,42).…”

Section: Pharmacologic Treatment In Turkeymentioning

confidence: 97%

“…These patients had decreased exercise capacity and sensation of dyspnea (41). Similarly, in Turkey, the most common reasons for non-adherence of PR were found to be the inability of understanding the efficacy and contents of PR program, lack of motivation, and transportation problems (41,42). According to recent guidelines, patients with remaining symptoms or limited functional capacity, and frequent exacerbations despite optimal pharmacologic treatment should receive PR (43)(44)(45)(46)(47).…”

Section: Pharmacologic Treatment In Turkeymentioning

confidence: 99%

The narrative review of chronic obstructive pulmonary disease management in Turkey: medical treatment, pulmonary rehabilitation and endobronchial volume reduction

Candemir¹

2021

J Thorac Dis

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Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. In Turkey, the prevalence of COPD has been shown at rates of 9.1% to 19.1%, and COPD was found to be the third leading cause of mortality and eighth leading cause of disability. In several national multicentral studies, a high rate of non-adherence to pharmacologic treatment according to GOLD was found to be high, and the most commonly prescribed treatment was the triple regimen. The most important non-pharmacologic treatment of COPD is pulmonary rehabilitation (PR), which is also highly recommended in Turkey, but it is also underutilized, like in other countries. Awareness of healthcare professionals and patients should increase in Turkey. The recommendations in content and modality of programs are similar to international guidelines.Another non-pharmacologic treatment is endobronchial volume reduction (EBVR). Although there is limited number of studies about EBVR, in national reports, the importance of patient selection, method, close follow-up after intervention, and applications in experienced centers are emphasized to decrease the economic burden of this expensive treatment. There is still great need for further randomized studies about pharmacologic and non-pharmacologic treatment and additionally, a close collaboration between healthcare professionals, physicians, professional societies of pulmonology, planners of reimbursement system, patients, patient advocacy groups and the general public should be established.

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“…However, the current study elicited training effects in a six-week program, irrespective of disease. Poor uptake and adherence remain a significant challenge to rehabilitation and there is a need for robust, well designed, trials to explore the overall effectiveness of PR, as well as exploring exacerbations post PR (Candemir, Kaymaz, & Ergun, 2017). Furthermore, improvements in exercise capacity and HRQoL from PR have been shown to diminish over time, therefore sustaining these enhancements is fundamental to ensure long-term well-being in those with a respiratory disease .…”

Section: Discussionmentioning

confidence: 99%

Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions

McCreery¹

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Effective rehabilitation strategies are paramount to improve physiological and psychological health in pulmonary disease. The aim of this thesis was to investigate traditional and alternative pulmonary rehabilitation strategies in those with chronic respiratory disease. Chapter Four found that traditional pulmonary rehabilitation (PR) was physiologically and psychologically effective, regardless of respiratory disease, with socioeconomic status being a key determinant of adherence. Chapter Five investigated the feasibility and acceptability of IMT. Children aged 10.8 ± 0.8 years with Cystic Fibrosis (CF) enjoyed the IMT intervention, perceiving improvements in their physical ability and psychosocial health. The care team highlighted that future interventions needed to be longer and to monitor engagement and adherence. Chapter Six assessed the effectiveness of an alternative rehabilitation strategy, using a four-week inspiratory muscle training (IMT) intervention, on lung function and heart rate variability in children with CF aged 10.8 ± 1.1 years. There were significant and clinically meaningful increases in respiratory muscle strength, a clinically meaningful decrease in sympathetic modulation, and decreases in respiratory symptoms. Subsequently, utilising the formative, physiological and psychological findings derived from Chapters Five and Six, an eight-week IMT intervention with live biofeedback, performed at 80% maximal inspiratory pressure, three times a week was implemented, with an eight-week optional IMT top-up. Overall, Chapter Seven found that eight weeks of IMT elicited significant increases in respiratory muscle strength, aerobic capacity and in CF-specific questionnaire domains in children (11.0 ± 2.2 years) with CF, which were maintained following the eight-week top-up period. Chapter Eight demonstrated significant improvements in inspiratory muscle strength and endurance after eight weeks, with sustained improvements in physiological health after 16-weeks in adults with bronchiectasis (64.5 ± 10.3 years). CF and bronchiectasis participants demonstrated high levels of adherence and reported competency and autonomy. Overall, IMT may be an effective and feasible alternative to pulmonary rehabilitation.

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The Reasons for Non-Adherence in Pulmonary Rehabilitation Programs

Cited by 5 publications

References 18 publications

Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients

Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients

The narrative review of chronic obstructive pulmonary disease management in Turkey: medical treatment, pulmonary rehabilitation and endobronchial volume reduction

Exploring Pulmonary Rehabilitation Strategies for those with Respiratory Conditions

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