So far, little was known about the variables that lead to premature pulmonary rehabilitation (PR) dropout in patients with chronic obstructive pulmonary disease (COPD). Patients who completed an eight-week PR program were studied for the prevalence and factors of early cessation. From 2013 to 2019, researchers examined a prospectively kept database of COPD patients who participated in a PR program. Patients aged 40 and above with a forced expiratory volume in one second (FEV1) / forced vital capacity (FVC) ratio of less than 0.7 were included. Subjects were classified as completers or non-completers according to whether or not they finished the 8-week PR program. The St-Respiratory George’s Questionnaire (SGRQ) was used to assess the quality of life, the Anxiety Inventory for Respiratory Disease (AIR) was used to assess anxiety, the modified Medical Research Council (mMRC) scale was used to assess dyspnea, and the Incremental Shuttle Walk Test was used to assess exercise capacity (ISWT).
The PR program enrolled 93 COPD patients (mean age=70.82 years, (FEV1) = 59.21% predicted, 51% male). Of these, 259 (26%) quit PR early, and 139 (53%) were men. Non-completers exhibited higher levels of dyspnea and anxiety, worse exercise tolerance, were younger, and had a lower quality of life at the start (all P<0.05). The following characteristics were independently linked with cessation from PR on multivariate analysis: younger age (P<0.001), raised anxiety symptoms (P<0.001), elevated dyspnea symptoms (P<0.01), and impaired exercise tolerance (P<0.002). Over a quarter of COPD patients dropped out of the PR program too soon. PR discontinuation was linked to younger age, increased dyspnea and anxiety symptoms, and decreased exercise capacity, but not to the degree of airflow obstruction.
Reference:www.resmedjournal.com/article/S0954-6111(22)00007-5/fulltext
