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What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review.
MedLine Citation:
PMID:  21596892     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Andrew Keating; Annemarie Lee; Anne E Holland
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chronic respiratory disease     Volume:  8     ISSN:  1479-9731     ISO Abbreviation:  Chron Respir Dis     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101197408     Medline TA:  Chron Respir Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  89-99     Citation Subset:  IM    
Affiliation:
Department of Physiotherapy, Alfred Hospital, Melbourne, Australia, School of Physiotherapy, The University of Melbourne, Melbourne, Australia.
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