Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
Can Respir J. 2020 Jan 7;2020:5146765. doi: 10.1155/2020/5146765. eCollection 2020.
The pulmonary rehabilitation (PR) is beneficial for COPD patients. Due to the poor rate of adherence, we evaluate the factors which will predict the nonadherence of PR.
We analyzed the data from a retrospective study of COPD patients who were enrolled to attend the PR program. Patients were classified as the adherence group and the nonadherence group according to completion of over 50% sessions during the 8-week PR program. Demographic characteristics, 6-minute walking distance (6MWD), COPD assessment test (CAT), modified Medical Research Council scale (mMRC), and emotional function were compared between two groups. Univariate and multivariable analyses were performed to determine the factors of poor adherence of PR.
Among 418 patients, 170 patients (40.7%) who completed less than 50% sessions of the PR program were categorized as "nonadherence." Compared to completers, "nonadherence" patients had more cigarette consumption, higher emotional score, less 6MWD, more exacerbation, using nebulizer frequently, and higher rate of smoking at enrollment. On multivariate analysis, more exacerbation frequency (odds ratio (OR) = 1.434, 95% confidence interval (CI): 1.191∼1.796, =0.046) and smoking at enrollment (OR = 3.349, 95% CI: 1.194∼6.302, =0.012) were predict factors associated with nonadherence of PR.
COPD patients with frequent exacerbation and smoking currently were more likely to be nonadherence during PR.
肺康复（PR）对 COPD 患者有益。由于依从率较差，我们评估了预测 PR 不依从的因素。
我们分析了参加 PR 计划的 COPD 患者回顾性研究的数据。根据在 8 周 PR 计划中完成超过 50%课程的情况，将患者分为依从组和不依从组。比较两组间的人口统计学特征、6 分钟步行距离（6MWD）、COPD 评估测试（CAT）、改良医学研究委员会量表（mMRC）和情绪功能。进行单变量和多变量分析以确定 PR 依从性差的因素。
在 418 名患者中，有 170 名（40.7%）完成 PR 计划少于 50%课程的患者被归类为“不依从”。与完成者相比，“不依从”患者的吸烟量更多，情绪评分更高，6MWD 更少，恶化更多，经常使用雾化器，并且在入组时吸烟率更高。多变量分析显示，更多的恶化频率（比值比（OR）=1.434，95%置信区间（CI）：1.191∼1.796，=0.046）和入组时吸烟（OR=3.349，95% CI：1.194∼6.302，=0.012）是与 PR 不依从相关的预测因素。
目前频繁恶化和吸烟的 COPD 患者在 PR 期间更有可能不依从。
