Serpa-Anaya D C, Hoyos-Quintero A M, Hernandez N L
Universidad del Valle, Cali, Valle del Cauca, Colombia.
Universidad Santiago de Cali, Cali, Valle del Cauca, Colombia.
Rehabilitacion (Madr). 2021 Apr-Jun;55(2):138-152. doi: 10.1016/j.rh.2020.09.007. Epub 2021 Feb 26.
Currently, several studies have identified low adherence to pulmonary rehabilitation in patients with COPD, despite the positive effects of the treatment. Patient adherence to pulmonary rehabilitation is affected by factors such as the absence of family support, and the presence of multiple comorbidities, respiratory distress, anxiety and depression. Given that there is no conclusive evidence about which of these factors are most influential in determining adherence to pulmonary rehabilitation in patients with COPD, we conducted this scoping review to analyse the available evidence on the factors influencing the adherence of patients with COPD to pulmonary rehabilitation programs (PRP). A wide literature search was carried out in Medline, Ovid, Science Direct, EMBASE, EBSCO and ISI-web of science, with prior definition of the selection criteria that included the factors associated with healthcare and adherence in patients with COPD in PRP. We used the adherence model proposed by the WHO as a conceptual framework. As a significant result, we found that factors in the dimension of illness (40%) and patient (30%) were the most frequently found dimensions in the studies, revealing that the design of pulmonary rehabilitation programs must take into account the specific needs of the patient. Further studies are needed to establish barriers and facilitators of adherence among COPD patients to PRP in the Colombian setting.
目前，多项研究已确定，尽管肺康复治疗对慢性阻塞性肺疾病（COPD）患者有积极效果，但患者对其依从性较低。患者对肺康复治疗的依从性受多种因素影响，如缺乏家庭支持、存在多种合并症、呼吸窘迫、焦虑和抑郁等。鉴于尚无确凿证据表明这些因素中哪些对决定COPD患者对肺康复治疗的依从性影响最大，我们进行了这项范围综述，以分析关于影响COPD患者对肺康复计划（PRP）依从性的因素的现有证据。我们在Medline、Ovid、Science Direct、EMBASE、EBSCO和科学网ISI上进行了广泛的文献检索，并事先确定了选择标准，其中包括与COPD患者在PRP中的医疗保健和依从性相关的因素。我们将世界卫生组织提出的依从性模型用作概念框架。一项重要结果是，我们发现疾病维度（40%）和患者维度（30%）的因素是研究中最常出现的维度，这表明肺康复计划的设计必须考虑患者的特定需求。需要进一步研究以确定哥伦比亚背景下COPD患者对PRP依从性的障碍和促进因素。
