BARRIERS TO ATTENDANCE IN PULMONARY REHABILITATION PROGRAMMES: AN OBSERVATIONAL STUDY

Dr. Ravi Shankar Mishra; Dr. Ashish Kumar Dubey

Volume : X, Issue : II, February - 2020

BARRIERS TO ATTENDANCE IN PULMONARY REHABILITATION PROGRAMMES: AN OBSERVATIONAL STUDY

Dr. Ravi Shankar Mishra, Dr. Ashish Kumar Dubey

Abstract :

Background: Pulmonary rehabilitation is an essential component of care for people with chronic obstructive pulmonary disease and is supported by strong scientific evidence. Despite this, many people with COPD do not complete their program or choose not to attend at all. Aim: This study was conducted to determine the factors associated to poor attendance in pulmonary rehabilitation programmes. Materials & Methods: A hospital based cross–sectional study was done including patients (both OPD and IPD) diagnosed with COPD over a period of 1.5 years. A pre–tested proforma was used for interview of patients. Questions were asked pertaining to socio–demographics, medical reasons, transport issues and psychological factors. Statistical analysis was done using SPSS v22 and other quantitative and qualitative tests were used as required. Significance level was fixed at p<0.05. Results: Out of 227 patients enrolled in the study, only 71 patients completed the 3 month follow up in PRP. Dropout percent was 68.72 with 95.51% being males and 4.48% females. Baseline characteristics showed 43.7% subjects in age group 61–70 years, most having primary level of education(45.5%), having a partner(70.1%) and working(59%). The subjects belonging to the more severe COPD groups I.e. C and D were 22.5% and 26.8% respectively. The mean Borg dyspnea score, Cat score and FEV1 improved drastically in all COPD groups during the course of the study(n=71). The main causes of non–attendance of PRP was not any specific reason(39.4%) followed by transportation problems and disease–related conditions. Conclusions: Attendance at PRPs is independently influenced by a lot of psychosocial factors. Proper counselling, instructions and coordination between the physician and the patient is mandatory for the success of such programmes