Barriers to pulmonary rehabilitation: Characteristics that predict patient attendance and adherence

Conal Hayton, Allan Clark, Sandra Olive, Paula Browne, Penny Galey, Emma Knights, Lindi Staunton, Andrew Jones, Emma Coombes, Andrew M. Wilson

Research output: Contribution to journalArticlepeer-review

175 Citations (Scopus)


Pulmonary rehabilitation (PR) is efficacious in chronic obstructive pulmonary disease (COPD). As completion rates of PR are poor, we wished to assess predictors of attendance and adherence.
We performed a retrospective analysis of 711 patients with COPD, who were invited to attend PR. Data were compared to allow predictors (gender, smoking status, attending partner, referral route, employment status, body mass index, forced expiratory volume in 1 s (FEV(1)), oxygen therapy (LTOT), oxygen saturations, chronic respiratory questionnaire (CRQ), shuttle walk distance, travel distance and time) of attendance (0 or >0 attendance) and adherence (< or >63% attendance) to be identified.
31.8% of patients referred for PR did not attend and a further 29.1% were non-adherent. Predictors of non-attendance were female gender, current smoker, and living alone. Predictors of non-adherence were extremes of age, current smoking, LTOT use, FEV(1), CRQ score and travelling distance. Multiple logistic regression revealed that LTOT and living alone were independent predictors of poor attendance and current smoking, poor shuttle walking distance and hospitalisations were independent predictors of poor adherence.
Smoking status, availability of social support and markers of disease severity were predictors of attendance and adherence to PR.
Original languageEnglish
Pages (from-to)401-407
Number of pages6
JournalRespiratory Medicine
Issue number3
Early online date19 Dec 2012
Publication statusPublished - 1 Mar 2013

Cite this