What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review
Abstract
Pulmonary rehabilitation is an essential component of care for people with chronic obstructive pulmonary disease (COPD) and is supported by strong scientific evidence. Despite this, many people with COPD do not complete their program or choose not to attend at all. The aim of this study was to determine the factors associated with uptake and completion of pulmonary rehabilitation for people with COPD. Seven electronic databases were searched for qualitative or quantitative studies that documented factors associated with uptake and completion of pulmonary rehabilitation in people with COPD. Two reviewers independently extracted data, which was synthesized to provide overall themes. Travel and transport were consistently identified as barriers to both uptake and completion. A lack of perceived benefit of pulmonary rehabilitation also influenced both uptake and completion. The only demographic features that consistently predicted non-completion were being a current smoker (pooled odds ratio 0.17, 95% confidence interval 0.10 to 0.32) and depression. The limited data available regarding barriers to uptake indicated that disruption to usual routine, influence of the referring doctor and program timing were important. In conclusion poor access to transport and lack of perceived benefit affect uptake of pulmonary rehabilitation. Current smokers and patients who are depressed are at increased risk of non-completion. Enhancing attendance in pulmonary rehabilitation will require more attention to transportation, support for those at risk of non-completion and greater involvement of patients in informed decisions about their care.
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Home-based videoconferencing groups overcame known barriers for attending face-to-face groups, such as transportation, travel distance, lack of time, inconvenience, and not being able to leave the care beneficiary.
“Home-based videoconferencing groups overcame known barriers for attending face-to-face groups, such as transportation, travel distance, lack of time, inconvenience [72,73], and not being able to leave the care beneficiary.”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [72]
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- Authors
- Keating, A., Lee, A., & Holland, A. E.
- Affiliations
- The University of Melbourne (AU)
- La Trobe University (AU)
- Corresponding author
- Holland, Anne E
- Venue
- Chronic Respiratory Disease
- Publisher
- SAGE Publications
- Published
- 2011-05
- Volume
- 8
- Issue
- 2
- Pages
- 89-99
- ISSN
- 1479-9723 (ISSN-L)
- 1479-9731
- OpenAlex
- W1955446240
- Cited by
- 583
- References
- 40
- Citations by year
- 2026: 26 · 2025: 44 · 2024: 41 · 2023: 61 · 2022: 46 · 2021: 62 · 2020: 60 · 2019: 40 · 2018: 33 · 2017: 52 · 2016: 34 · 2015: 30 · 2014: 19 · 2013: 15 · 2012: 17
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Chronic Respiratory Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- chronic obstructive pulmonary disease, pulmonary rehabilitation, rehabilitation uptake, rehabilitation completion, barriers to care, perceived benefits, current smoking, depression, patient decision-making
- MeSH terms
- Depression, Humans, Health Knowledge, Attitudes, Practice, Patient Compliance, Perception, Physician-Patient Relations, Smoking, Social Support, Transportation, Treatment Refusal, Pulmonary Disease, Chronic Obstructive
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