Comparison and analysis of the adherence of pulmonary rehabilitation in patients in different periods of chronic obstructive pulmonary disease / 天津医药

ABSTRACT

Objective To explore the differences and infection factors of adherence of pulmonary rehabilitation (PR) in patients with different periods of chronic obstructive pulmonary disease (COPD). Methods The 304 patients were randomly distributed into two groups, stable COPD with PR group (n=178) and acute exacerbation COPD (AECOPD) with PR group (n=126). The course of PR was 12 weeks. According to the adherence definition (practical time of accompolish PR programm>70%of that planned time), patients were divided into good adherence group (n=115) and bad adherence group (n=189). The practical-perform time of PR, proportion of good adherence and PR quitting were compared between two groups. Basic data were collected and analyzed in two groups of patients. After the pulmonary rehabilitation, binary Logistic regression was used to analyse the compliance of pulmonary rehabilitation. Results The practical-perform time of PR and the proportion of good adherence were significantly higher in stable COPD with PR group than those of AECOPD with PR group (5 641.5±1 080.1 min vs. 4 426.5± 1 046.8 min,46.7%vs. 25.4%). The PR quitting proportion (10.6%, 21/199) was significantly lower in stable COPD with PR group than that of AECOPD with PR group (26.7%, 46/172). Compared with AECOPD PR group, the income level and 6 minutes walking distance (MWD) were significantly higher in stable COPD PR group, and the everage age, proportion of tabacco-exposed, MRC score and CAT score were significantly lower in stable COPD group (P<0.05). Logistic regression analysis showed that older-age, tabacco-exposed, higher MRC score and CAT score were risk factors for PR adherence, while the higher income level (≥3 000 yuan) and longer 6MWD were protective factors for PR time-adherence in patients with COPD (P<0.05). Conclusion The time adherence of COPD patients, who undergo pulmonary rehabilitation, is disappointing, especially post-exacerbation. Good adherence would be expected in younger age, non tabacco-exposed, higher income level and better health-related quality of life.