Pulmonary rehabilitation: uptake and completion profile of patients with COPD

Background: Pulmonary rehabilitation (PR) is effective in the management of chronic obstructive pulmonary disease (COPD) patients. 33% of patients referred for PR do not start the programme. Aim: To examine the relationship between participation in outpatient PR and baseline measures of disease severity and psychosocial variables in COPD patients. Methods: In an observational study and prior to their first outpatient PR appointment, COPD patients completed outcome measures of depression (Brief Assessment Depression Card), social support (Duke Social Support Index), multidimensional health locus of control (MHLC) and COPD severity (Medical Research Council dyspnea score). Data on attendance at the PR appointments were obtained from the PR register. Results: Fifty-one patients (mean age 77.2 year, male= 20), completed the study. Results indicate that in a patient, the presence of depression has a moderate, but statistically significant association (p=0.02) with the uptake of PR. There was no significant correlation between uptake status and any of the domains of MHLC, DSSI or MRC (p>0.005). Conclusion: Patients with COPD and depression are less likely to take up a referral to PR compared to those without depression. None of social support, HLC and COPD severity has a relationship with the uptake or completion of outpatient PR.