Attendance at pulmonary rehabilitation classes: an exploration of demographic, physiological and psychological factors that predict completion of treatment

Chron Respir Dis. 2014 May;11(2):95-102. doi: 10.1177/1479972314527469. Epub 2014 Mar 21.


Pulmonary rehabilitation (PR) is an effective treatment for people with chronic obstructive pulmonary disease (COPD). However, uptake and adherence to rehabilitation is poor and non-adherence is associated with poorer clinical outcomes. This study investigated the factors that might predict an individual completing his/her PR programme. Demographic, physiological and psychological data were collected from routine assessment information. Non-completers (N = 213) who dropped out after initial assessment were compared with completers (N = 438) who attended all 6 weeks of PR programme. Regression analysis indicated that smoking status was the strongest predictor for completing PR programme, that is, ex-smokers were 2.6 times (95% confidence interval (CI) = 1.7-3.9) and those who had never smoked were 2.5 times (95% confidence interval (CI) = 1.1-5.7) more likely to complete in comparison with those who were current smokers. Scoring better on psychological well-being measures (odds ratio = 1.6; 95% CI = 1.2-1.9) was also a strong predictor. The findings suggest the areas that could be addressed to enhance adherence to rehabilitation, for example, targeted interventions for clients who continue to smoke and for those who require support for psychological distress.

Keywords: Chronic obstructive pulmonary disease; adherence to treatment; psychological factors; pulmonary rehabilitation; smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / psychology
  • Depression / psychology
  • Dyspnea / etiology
  • Emotions
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance* / psychology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Retrospective Studies
  • Smoking
  • Smoking Cessation