Reeve J1, Jepsen N1,2, Candy S2, Coomarasamy C3
1Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand, 2Counties Manukau Health, Physiotherapy, Auckland, New Zealand, 3Counties Manukau Health, Health Intelligence and Informatics, Auckland, New Zealand
Background: Chronic respiratory diseases, such as chronic obstructive pulmonary disease, are a worldwide public health problem, leading to substantial morbidity and mortality. Pulmonary rehabilitation (PR) is a gold standard intervention for these diseases, yet attendance and completion rates of PR programmes are poor. Counties Manukau Health (CMH), in Auckland has a high prevalence of chronic respiratory disease and has a population which comprises large Māori and Pacific Island populations, who are disproportionately affected by chronic respiratory disease.
Purpose: The aim of this study was to investigate patient characteristics that may affect engagement with the CMH programme and identify factors that predict completion of the programme.
Methods: A retrospective analysis was performed, using routinely collected data of patients who had been referred to the PR programme at CMH between January 2010 and December 2015. Data were analysed to compare demographic and clinical outcomes of patients who completed, did not complete or did not attend the programme. Regression analysis was used to identify factors predicting completion.
Results: Data were collected on 2756 patients referred to the PR programme at CMH in the period under investigation. Of these, 1716 (62.3%) either never attended or did not complete the programme. Significant differences were found between completers, non-completers or non-attenders in demographic and clinical characteristics. Ethnicity, older age and poorer six-minute walk test distance at commencement were significant predictors of non-completion.
Conclusion(s): Those of an older age group and those with poorer exercise tolerance at programme commencement are less likely to complete PR and these findings echo others findings overseas. To our knowledge, the differences relating to ethnicity have not been demonstrated elsewhere and our findings demonstrate that New Zealand and Pacific Island indigenous peoples are much less likely to complete the PR programme than European people, despite being disproportionately affected by chronic respiratory disease.
Implications: In order to improve engagement with PR and reduce population health inequities, consideration to the method of delivery of PR across different ethnic groups, in varying age groups and in those presenting with poorer exercise tolerance should be given.
Keywords: COPD, Pulmonary Rehabilitation, Completion rates
Funding acknowledgements: None
Purpose: The aim of this study was to investigate patient characteristics that may affect engagement with the CMH programme and identify factors that predict completion of the programme.
Methods: A retrospective analysis was performed, using routinely collected data of patients who had been referred to the PR programme at CMH between January 2010 and December 2015. Data were analysed to compare demographic and clinical outcomes of patients who completed, did not complete or did not attend the programme. Regression analysis was used to identify factors predicting completion.
Results: Data were collected on 2756 patients referred to the PR programme at CMH in the period under investigation. Of these, 1716 (62.3%) either never attended or did not complete the programme. Significant differences were found between completers, non-completers or non-attenders in demographic and clinical characteristics. Ethnicity, older age and poorer six-minute walk test distance at commencement were significant predictors of non-completion.
Conclusion(s): Those of an older age group and those with poorer exercise tolerance at programme commencement are less likely to complete PR and these findings echo others findings overseas. To our knowledge, the differences relating to ethnicity have not been demonstrated elsewhere and our findings demonstrate that New Zealand and Pacific Island indigenous peoples are much less likely to complete the PR programme than European people, despite being disproportionately affected by chronic respiratory disease.
Implications: In order to improve engagement with PR and reduce population health inequities, consideration to the method of delivery of PR across different ethnic groups, in varying age groups and in those presenting with poorer exercise tolerance should be given.
Keywords: COPD, Pulmonary Rehabilitation, Completion rates
Funding acknowledgements: None
Topic: Cardiorespiratory
Ethics approval required: No
Institution: Counties Manukau Health
Ethics committee: NZ Health and Disability Ethics Committee
Reason not required: Audit data only
All authors, affiliations and abstracts have been published as submitted.
