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Cited by 203Chronic Obstructive Pulmonary Disease (COPD) ResearchCardiac Health and Mental HealthMedical Practices and Rehabilitation

Drop-out and attendance in pulmonary rehabilitation: the role of clinical and psychosocial variables

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Fischer, Maarten J., Scharloo, Margreet, Abbink, Jannie J., van ‘t Hul, Alex J., van Ranst, Dirk, Rudolphus, Arjan, Weinman, John, Rabe, Klaus F. +1 more·2009·Respiratory Medicine
DOI 10.1016/j.rmed.2008.11.020
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Abstract

Background In spite of the well-demonstrated benefits for patients with COPD, pulmonary rehabilitation programmes show considerable drop-out and suboptimal attendance rates. The purpose of this prospective study is to examine causes for drop-out and non-attendance during a 12 week multidisciplinary pulmonary rehabilitation programme, and to investigate whether sociodemographic and medical factors as well as patients' perception of their illness are related to drop-out and non-attendance.Methods Two hundred and seventeen patients with COPD who were referred to a rehabilitation centre participated in this multicentre study. Prior to treatment, patients received a questionnaire, which included the Illness Perception Questionnaire-Revised. Clinical data were drawn from medical records. Drop-out and attendance were recorded during the programme.Results Fifty patients (23%) did not complete the rehabilitation course, of which half was due to medical reasons (e.g. exacerbations, hospitalisations). Non-completion could not be predicted by baseline sociodemographic, clinical or psychological variables. Patients who declined treatment did not differ from patients who dropped out due to medical reasons. On average, patients attended 92% of all scheduled appointments. Of all missed appointments, approximately 20% were accountable to factors beyond patients' control (e.g. absent therapists, hospitalisations). Smoking, living alone, a lower fat free mass and lower confidence in treatment increased the chance of patients not attending an appointment during rehabilitation.Conclusion In general, adherence in rehabilitation is high. However, paying attention to patients' nutritional status and creating a positive expectation of treatment during referral and intake appear to be important if one aims to optimise patients' attendance during rehabilitation.

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Authors
Fischer, M. J., Scharloo, M., Abbink, J. J., van ‘t Hul, A. J., van Ranst, D., Rudolphus, A., Weinman, J., Rabe, K. F., & Kaptein, A. A.
Affiliations
  • Leiden University Medical Center (NL)
  • Rijnlands Revalidatie Centrum (NL)
  • Sint Franciscus Gasthuis (NL)
Corresponding author
Fischer, Maarten J.
ORCID
Venue
Respiratory Medicine
Publisher
Elsevier BV
Published
2009-10
Volume
103
Issue
10
Pages
1564-1571
ISSN
0954-6111 (ISSN-L)
DOI
10.1016/j.rmed.2008.11.020
OpenAlex
W2136171956
Cited by
203
References
41
Citations by year
2026: 3 · 2025: 9 · 2024: 8 · 2023: 14 · 2022: 14 · 2021: 15 · 2020: 10 · 2019: 15 · 2018: 6 · 2017: 21 · 2016: 13 · 2015: 13 · 2014: 12 · 2013: 19 · 2012: 12
FWCI
8.41
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
pulmonary rehabilitation, chronic obstructive pulmonary disease, treatment discontinuation, rehabilitation attendance, missed appointments, illness perception, Illness Perception Questionnaire-Revised, smoking, living alone, fat-free mass, treatment confidence, nutritional status, multidisciplinary rehabilitation
MeSH terms
Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Compliance, Patient Dropouts, Prospective Studies, Surveys and Questionnaires, Pulmonary Disease, Chronic Obstructive

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