PMID- 34856155
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20221115
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Print)
IS  - 0003-9993 (Linking)
VI  - 103
IP  - 6
DP  - 2022 Jun
TI  - Predictors of Outpatient Pulmonary Rehabilitation Uptake, Adherence, Completion, 
      and Treatment Response Among Male U.S. Veterans With Chronic Obstructive 
      Pulmonary Disease.
PG  - 1113-1121.e1
LID - S0003-9993(21)01573-2 [pii]
LID - 10.1016/j.apmr.2021.10.021 [doi]
AB  - OBJECTIVE: To examine predictors of uptake (never start), adherence (drop out), 
      and completion of pulmonary rehabilitation (PR), as well as PR treatment response 
      based on minimal clinically important difference (MCID) on the 6-minute walk test 
      (6MWT) distance and Chronic Respiratory Questionnaire-Self-Report (CRQ-SR). 
      DESIGN: Retrospective, cohort study. SETTING: Veterans Health Administration. 
      PARTICIPANTS: U.S. veterans with chronic obstructive pulmonary disease (COPD) 
      (N=253) referred to PR between 2010 and 2018. INTERVENTIONS: Outpatient PR 
      program. MAIN OUTCOME MEASURES: Participants completed baseline (time 1) measures 
      of depression (Beck Depression Inventory-II), health-related quality of life 
      (CRQ-SR), self-efficacy (Exercise Self-Regulatory Efficacy Scale [Ex-SRES]), and 
      COPD knowledge. Exercise capacity was assessed with the 6MWT. Participants who 
      completed all 18 sessions of PR repeated assessments (time 2). Logistic 
      regression models examined predictors of uptake, adherence, and completion of PR 
      as well as treatment response based on MCID. RESULTS: Participants were referred 
      to PR with 24.90% never starting, 28.90% dropping out, and 46.20% completing. No 
      differences emerged between never starters and dropouts. Having a history of any 
      cancer increased the likelihood of completing PR (vs never starting; odds ratio 
      [OR], 3.18; P=.003). Greater CRQ-SR dyspnea score, indicating less dyspnea, was 
      associated with increased likelihood of completing PR (OR, 1.12; P=.006). Past 
      smoking compared with current smoking was associated with increased likelihood of 
      completion (OR, 3.89; P</=.002). Those without a history of alcohol use disorder 
      had increased likelihood of completing PR (OR, 2.23; P=.048). Greater baseline 
      6MWT distance was associated with lower likelihood of achieving MCID in 6MWT (OR, 
      0.99; P<.001). Greater Ex-SRES was associated with decreased likelihood of 
      achieving 6MWT MCID (OR, 0.98; P=.023). CONCLUSIONS: Findings suggest that early 
      psychoeducation on dyspnea management and smoking and alcohol cessation may 
      increase completion of PR.
CI  - Published by Elsevier Inc.
FAU - Bamonti, Patricia M
AU  - Bamonti PM
AD  - VA New England Geriatric Research Education and Clinical Center (GRECC), VA 
      Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical 
      School, Boston, MA. Electronic address: patricia.bamonti@va.gov.
FAU - Boyle, Julia T
AU  - Boyle JT
AD  - VA Boston Healthcare System, Boston, MA.
FAU - Goodwin, Christina L
AU  - Goodwin CL
AD  - VA Boston Healthcare System, Boston, MA.
FAU - Wan, Emily S
AU  - Wan ES
AD  - Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 
      Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Channing 
      Division of Network Medicine, Brigham and Women's Hospital, Boston, MA.
FAU - Silberbogen, Amy K
AU  - Silberbogen AK
AD  - VA Boston Healthcare System, Boston, MA; Boston University School of Medicine, 
      Boston, MA.
FAU - Finer, Elizabeth B
AU  - Finer EB
AD  - Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 
      Boston, MA.
FAU - Moy, Marilyn L
AU  - Moy ML
AD  - Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 
      Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA.
LA  - eng
GR  - IK2 RX002165/RX/RRD VA/United States
GR  - IK2 RX003527/RX/RRD VA/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20211129
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Cohort Studies
MH  - Dyspnea/rehabilitation
MH  - Exercise Tolerance
MH  - Humans
MH  - Male
MH  - Outpatients
MH  - *Pulmonary Disease, Chronic Obstructive
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Veterans
PMC - PMC9662698
MID - NIHMS1834255
OTO - NOTNLM
OT  - Pulmonary disease, chronic obstructive
OT  - Rehabilitation
EDAT- 2021/12/03 06:00
MHDA- 2022/06/09 06:00
PMCR- 2022/11/14
CRDT- 2021/12/02 20:10
PHST- 2021/06/16 00:00 [received]
PHST- 2021/09/03 00:00 [revised]
PHST- 2021/10/11 00:00 [accepted]
PHST- 2021/12/03 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2021/12/02 20:10 [entrez]
PHST- 2022/11/14 00:00 [pmc-release]
AID - S0003-9993(21)01573-2 [pii]
AID - 10.1016/j.apmr.2021.10.021 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2022 Jun;103(6):1113-1121.e1. doi: 
      10.1016/j.apmr.2021.10.021. Epub 2021 Nov 29.