Predictors of dropout from a supervised pulmonary rehabilitation programme

Introduction: Pulmonary rehabilitation (PR) is an established programme for the management of patients with chronic obstructive pulmonary disease (COPD). However, a significant proportion of patients drop out of PR. Aims: The aim of this study is to determine factors that may contribute to dropout from our PR programme. Methods: We reviewed medical charts of 41 COPD patients who participated in a 12-week supervised outpatient PR programme in Fukujuji Hospital. Data collected included clinical and demographic characteristics, physiological parameters and quality of life. We compared data from patients who failed to complete PR with those who completed it to determine predictors of dropout. Dropouts were defined as those who attended fewer than 67% of the sessions. Results: 10 of the 41 patients (24.4%) dropped out of the PR programme. When compared to completers, dropouts had significantly lower levels of exercise capacity as measured by the incremental shuttle walking test (p=0.017) and borderline significantly higher SGRQ impacts score (p=0.082). There were no significant differences between dropouts and completers for age, sex, smoking status, body mass index, dyspnea, FEV1 % predicted, exacerbations, or comorbidities. Conclusions: Impaired baseline exercise capacity was a significant predictor of PR dropout. Special attention should be paid to those who have significantly lower levels of exercise capacity to avoid dropout from PR.