Adherence to Exercise Training in COPD Patients- Factors that Predict Patient Adherence and Non-Adherence- A Preliminary Study.

Corresponding Author:
Dr. Chaya S. K.,
Department of Pulmonology,
JSS Medical College (JSSAHER),
Mysore, Karnataka, India.
E-mail: chaya.sindaghatta@gmail.com

ABSTRACT

BACKGROUND

It is well documented that exercise training for COPD patients improve the quality of life, and decrease hospitalization and therefore decreased the mortality. Exercise implementation may be influenced by many factors and it varies considerably between countries. There is an acute need to understand the factors that predict non-adherence and adherence to PR with a view to improve uptake. We wanted to determine the percentage of adherence to 12 weeks of exercise training program and to know the reason for non-adherence and the factors that motivated them to adhere to the exercise rehabilitation program.

METHODS

One hundred and thirty-four patients with COPD referred for rehabilitation participated in this study. The interview was conducted to the subjects dropped from the training and to subjects adhered to the intervention. Wide range of open-ended questions as well as probing questions, such as why they had decided to attend or not attend the exercise training program, and why they had decided to continue or drop out were asked. Interviews were carried out and audio-taped with the consent of the participant. The reasons for adherence and non-adherence were listed and analysed using descriptive statistics.

RESULTS

The COPD patients’ adherence to three month of exercise training was 44.7% and drop out was 55.22%. The reason for adherence to the exercise regimen to end was the influence of the referring doctor (15%), understood the benefits and self-motivated (31.66%), positively influenced by other patients attending the exercise rehabilitation therefore motivated (26.66%) and increased self-confidence (26.66%). The reason for non-adherence for both the type of intervention was not affordable (29.72%), no attender (family support) to accompany (13.51%), LTOT use (9.45%), breathlessness and leg fatigue (10.81%), absence of therapist (6.75%), travelling distance (6.75%), hospitalizations (18.91%), felt that they can do at home (2.70%), shifting/migration (1.35%).

CONCLUSIONS

Adherence of COPD patients to exercise rehabilitation program for twelve weeks is moderate.

KEY WORDS

Adherence, COPD, Pulmonary Rehabilitation, Exercise Training, Factors Predict, Non-Adherence