PMID- 35091205
OWN - NLM
STAT- MEDLINE
DCOM- 20220331
LR  - 20220401
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 193
DP  - 2022 Mar
TI  - Predictors of premature discontinuation and prevalence of dropouts from a 
      pulmonary rehabilitation program in patients with chronic obstructive pulmonary 
      disease.
PG  - 106742
LID - S0954-6111(22)00007-5 [pii]
LID - 10.1016/j.rmed.2022.106742 [doi]
AB  - INTRODUCTION: To date, very little is known about the risk factors that 
      contribute to premature discontinuation (dropout) from pulmonary rehabilitation 
      (PR) in patients with chronic obstructive pulmonary disease (COPD). We examined 
      prevalence and predictors of premature discontinuation in patients who 
      participated in an eight week PR program. METHODS: We analyzed a prospectively 
      maintained data-base of patients with COPD who attended a PR program from 2013 to 
      2019. We included patients 40 years or older with forced expiratory volume in 1 s 
      (FEV(1))/forced vital capacity (FVC) ratio less than 0.7. Subjects were assigned 
      completers or non-completers based on whether they completed the 8-week PR 
      program. Quality of life was measured using the St-George's Respiratory 
      Questionnaire (SGRQ), anxiety using the Anxiety Inventory for Respiratory disease 
      (AIR), dyspnea using the modified Medical Research Council (mMRC) scale, and 
      exercise capacity using the Incremental Shuttle Walk Test (ISWT). RESULTS: Nine 
      hundred nighty three COPD patients (mean age = 70.82 years, FEV(1) = 59.21% 
      predicted, 51% male) entered the PR program. Of these, 259 (26%) discontinued PR 
      prematurely and 139 (53%) were male. Compared with completers, non-completers had 
      elevated symptoms of dyspnea and anxiety, had reduced exercise tolerance, were 
      younger, and had poorer quality of life at entry (all p < 0.05). On multivariate 
      analysis, the following variables were independently associated with 
      discontinuation from PR: younger age (p < 0.001), elevated symptoms of anxiety 
      (p < 0.001), elevated symptoms of dyspnea (p < 0.01) and reduced exercise 
      tolerance (p < 0.002). CONCLUSION: Over a quarter of COPD patients discontinued 
      the PR program prematurely. Discontinuation of PR was associated with younger 
      age, elevated symptoms of dyspnea and anxiety, and reduced exercise capacity, but 
      not with severity of airflow obstruction.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Yohannes, Abebaw Mengistu
AU  - Yohannes AM
AD  - Azusa Pacific University, Department of Physical Therapy, Azusa, USA. Electronic 
      address: ayohannes@apu.edu.
FAU - Casaburi, Richard
AU  - Casaburi R
AD  - Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical 
      Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA. Electronic address: 
      casaburi@ucla.edu.
FAU - Dryden, Sheila
AU  - Dryden S
AD  - St. Annes Primary Care Center, Lytham, Lancashire, United Kingdom. Electronic 
      address: sheilaannedryden@yahoo.co.uk.
FAU - Hanania, Nicola Alexander
AU  - Hanania NA
AD  - Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, 
      Houston, USA. Electronic address: hanania@bcm.edu.
LA  - eng
PT  - Journal Article
DEP - 20220120
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
SB  - IM
MH  - Aged
MH  - Dyspnea/complications/etiology
MH  - Exercise Tolerance
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Male
MH  - Prevalence
MH  - *Pulmonary Disease, Chronic Obstructive
MH  - *Quality of Life
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anxiety
OT  - COPD
OT  - Depression
OT  - Dropout
OT  - Predictors
OT  - Pulmonary rehabilitation
EDAT- 2022/01/30 06:00
MHDA- 2022/04/01 06:00
CRDT- 2022/01/29 05:37
PHST- 2021/09/12 00:00 [received]
PHST- 2021/12/29 00:00 [revised]
PHST- 2022/01/10 00:00 [accepted]
PHST- 2022/01/30 06:00 [pubmed]
PHST- 2022/04/01 06:00 [medline]
PHST- 2022/01/29 05:37 [entrez]
AID - S0954-6111(22)00007-5 [pii]
AID - 10.1016/j.rmed.2022.106742 [doi]
PST - ppublish
SO  - Respir Med. 2022 Mar;193:106742. doi: 10.1016/j.rmed.2022.106742. Epub 2022 Jan 
      20.