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Lack of perceived benefit and inadequate transport influence uptake and completion of pulmonary rehabilitation in people with chronic obstructive pulmonary disease: a qualitative study
Open accessAbstract
QUESTION: What prevents people with chronic obstructive pulmonary disease (COPD) from attending and completing pulmonary rehabilitation programs? DESIGN: Qualitative design using semi-structured interviews. PARTICIPANTS: 19 adults with COPD who had declined to participate and 18 adults with COPD who had not completed a pulmonary rehabilitation program at a metropolitan teaching hospital. RESULTS: A lack of perceived benefit from pulmonary rehabilitation was a significant theme for those who chose not to participate in pulmonary rehabilitation. Participants expressed perceptions that exercise was not a worthwhile treatment, or that they were already doing enough exercise at home. Difficulty getting to the program related to poor mobility, lack of transport, and cost of travel was a significant theme, expressed both by those who chose not to participate and those who did not complete. Another major theme associated with both uptake and completion involved being unwell, with participants indicating that the burden of COPD and other comorbidities impacted on attendance. Minor themes involved competing demands on time, older age, fatigue, program timing, and lack of social support. CONCLUSION: Many people with COPD who elect not to take up a referral to pulmonary rehabilitation perceive that they would not experience any health benefits from attendance. Difficulties with travel to the program and being unwell are barriers to both uptake and completion. Improving attendance at pulmonary rehabilitation requires consideration of how information regarding the proven benefits of pulmonary rehabilitation can be conveyed to eligible patients, along with flexible program models that facilitate access and accommodate co-morbid disease.
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“Exacerbations of chronic disease, lack of time, transport issues, motivation, and lack of perceived benefit of pulmonary rehabilitation are well documented as reasons for withdrawal or dropout in studies of pulmonary rehabilitation.26,27”
From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [27]
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Barriers to pulmonary rehabilitation: Characteristics that predict patient attendance and adherence
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“Barriers, which prevent patients from attending PR, include disruption of their everyday routine, travel or transportation difficulties, inconvenient timing of the program, lack of perceived benefit, lack of social support, low self-confidence, and fear of being breathless or exacerbating existing medical problems [2,…”
Background
Metadata
- Authors
- Keating, A., Lee, A. L., & Holland, A. E.
- Affiliations
- La Trobe University (AU)
- The University of Melbourne (AU)
- Corresponding author
- Holland, Anne E.
- Venue
- Journal of Physiotherapy
- Publisher
- Elsevier BV
- Published
- 2011
- Volume
- 57
- Issue
- 3
- Pages
- 183-190
- ISSN
- 1836-9553 (ISSN-L)
- OpenAlex
- W2124926005
- Cited by
- 159
- References
- 42
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 8 · 2023: 9 · 2022: 13 · 2021: 9 · 2020: 18 · 2019: 11 · 2018: 10 · 2017: 14 · 2016: 6 · 2015: 5 · 2014: 17 · 2013: 8 · 2012: 9
- FWCI
- 9.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of physiotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- chronic obstructive pulmonary disease, pulmonary rehabilitation, barriers to uptake, program completion, perceived benefits, physical activity, transport barriers, mobility (physical function), comorbidities, patient attendance, social support, fatigue
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Patient Compliance, Quality of Life, Social Support, Transportation, Exercise, Pulmonary Disease, Chronic Obstructive, Qualitative Research
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