Background

Pulmonary rehabilitation programs (PRP) are important for people with symptomatic COPD.

Research Questions

What proportion of people with COPD who are suitable for a PRP go on to be referred? Do clinical or sociodemographic characteristics influence the odds of whether those who are suitable for a PRP go on to be referred? What factors influence people’s interest in participating in a pulmonary rehabilitation program?

Study Design and Methods

People with COPD who appeared appropriate for a PRP were sequentially recruited from three tertiary hospitals in Australia. Variables such as age, sex, lung function, smoking status, and interest in participating in a PRP were collected through interviews and reviewing the medical records. Referrals to PRPs were prospectively tracked through the electronic referral system, medical records, and discussion with the participant or the physiotherapists responsible for coordinating the PRPs.

Results

Six hundred eighty-two people with COPD were approached, 468 consented, and data were available on 391 (No. [%] or mean ± SD; 215 males [55%], age 69 ± 10 years, FEV₁ 49 ± 19 %predicted). Of the 156 participants deemed suitable for a PRP, 74 (47%, 95% vCI, 40-55) were referred to a PRP. Among participants who were deemed suitable for a PRP, the only variable that separated those who were from those who were not referred was interest in attending a PRP (mean difference in interest on the visual analog scale [VAS]; 22 units, 95% CI, 12-32). Introverted personality traits and feelings of unworthiness reduced interest in attending a PRP.

Interpretation

Among people with COPD who were suitable for a PRP, referral from the tertiary hospital setting was suboptimal. Suitable participants who were not referred showed lower interest in attending a PRP. There were novel complex individual barriers that reduced one’s interest in participating in a PRP.

中文翻译：

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对影响 COPD 患者肺康复计划转诊的因素的评估

背景

肺康复计划 (PRP) 对于有症状的 COPD 患者很重要。

研究问题

有多少适合 PRP 的 COPD 患者继续被转诊？临床或社会人口学特征是否会影响适合 PRP 的人是否继续被转诊的几率？哪些因素会影响人们参与肺康复计划的兴趣？

研究设计和方法

从澳大利亚的三家三级医院依次招募了适合 PRP 的 COPD 患者。年龄、性别、肺功能、吸烟状况和参与 PRP 的兴趣等变量是通过访谈和审查医疗记录收集的。通过电子转诊系统、医疗记录以及与参与者或负责协调 PRP 的物理治疗师的讨论，对 PRP 的转诊进行前瞻性跟踪。

结果

接触了 682 名 COPD 患者，其中 468 人同意，391 人的数据可用（编号 [%] 或平均值 ± SD；215 名男性 [55%]，年龄 69 ± 10 岁，FEV ₁ 49 ± 19 %预料到的）。在被认为适合 PRP 的 156 名参与者中，有 74 名（47%，95% vCI，40-55）被转介到 PRP。在被认为适合 PRP 的参与者中，将那些与未推荐的参与者区分开来的唯一变量是对参加 PRP 的兴趣（视觉模拟量表 [VAS] 上的兴趣平均差异；22 个单位，95% CI , 12-32)。内向的性格特征和自卑感降低了参加 PRP 的兴趣。

解释

在适合 PRP 的 COPD 患者中，从三级医院转诊并不理想。没有被推荐的合适参与者对参加 PRP 的兴趣较低。有新的复杂的个人障碍降低了参与 PRP 的兴趣。