Seasonal variation and living alone are related to pulmonary rehabilitation non-completion

Table 1 Participant's baseline demographic data n (%)

	Completers (n = 85)	Non-completers (n = 26)	P vaule
Age (yr)	67.4 ± 9.1	67.2 ± 9.5	0.93
Sex (female)	36 (42.3)	12 (46.2)	0.822
Social support (living alone)	22 (25.9)	14 (53.8)	0.015
Currently smoking	6 (7.1)	4 (15.4)	0.24
Programs commencing in Winter	28 (32.9)	17 (65.4)	0.006
FEV1% predicted	55.4 ± 22.4	51.4 ± 22.5	0.452
FVC% predicted	76.8 ± 18.5	71.4 ± 19.5	0.243
Charlson Co-morbidity index	1.9 ± 1.1	1.9 ± 1.0	0.851
BODE index	2.6 ± 1.9	3.1 ± 2.1	0.256
BMI (kg/m2)	27.6 ± 5.2	26.6 ± 4.2	0.383
Quadriceps strength (%)	62.3 ± 22.5	60.1 ± 21.8	0.681
6MWD (m)	406 ± 107	350 ± 134	0.03
COPD self-efficacy score (mean score/question)	2.8 ± 0.8	2.8 ± 0.8	0.924
Chronic respiratory Questionnaire	86.7 ± 21.5	73.2 ± 29.9	0.012
CRQ-dyspnea domain (mean score/question)	4.2 ± 1.4	3.9 ± 1.3	0.279
CRQ -fatigue domain (mean score/question)	3.6 ± 1.3	3.1 ± 1.0	0.064
CRQ-emotional domain (mean score/question)	4.6 ± 1.2	4.3 ± 1.3	0.179
CRQ-mastery domain (mean score/question)	4.7 ± 1.3	4.4 ± 1.4	0.456

Continuous data expressed as the mean ± SD. FEV1: Forced expiratory volume in one second; FVC: Forced expiratory volume; BODE: Body-mass-index, Airflow Obstruction, Dyspnea, and Exercise Capacity; BMI: Body mass index; 6MWD: Six minute walk distance; COPD: Chronic obstructive pulmonary disease; CRQ: Chronic respiratory questionnaire.

Table 2 Binary logistic regression model for a non-completer in pulmonary rehabilitation

	β	SE	Waldχ2	P	Odds ratio (Expβ)	95%CI for Expβ
Univariate analysis
Six minutes walk distance	-0.004	0.002	4.435	0.035	0.996	0.992–1.000
CRQ fatigue domain	-0.351	0.192	3.357	0.067	0.704	0.483-1.025
CRQ total score	-0.024	0.01	5.662	0.017	0.976	0.957-0.996
Social support-lives alone	1.19	0.465	6.548	0.01	3.288	1.321-8.182
Programs commenced in Winter	-1.347	0.472	8.127	0.004	0.260	0.103-0.656
Multivariate analysis
Social support-lives alone	1.073	0.528	4.134	0.042	2.925	1.039-8.229
Programs commenced in Winter	-1.366	0.534	6.541	0.011	0.255	0.090-0.727

Only variables with P < 0.1 are shown in the table. There was a strong correlation between the chronic respiratory questionnaire (CRQ) total score and the CRQ fatigue domain (r = 0.783), therefore only the CRQ total score was assessed in the multivariate analysis.

Table 3 Non-completers responses about their pulmonary rehabilitation experience

	Yes	No	Undecided/no comment
Did you like the initial assessment?	15	2	3
Did you like the education sessions?	18	0	2
Did you like the exercise sessions?	12	2	6
Did you notice any benefits from participating in the program?	16	1	3
Do you believe pulmonary rehabilitation can help you manage your condition?	17	0	3

Table 4 Reasons given for pulmonary rehabilitation non-completion

	Yes	No	Undecided/no comment
Personal factors
Did an illness affect you completing the program?	13	5	2
Did an injury affect you completing the program?	3	16	1
Did family commitments affect you completing the program?	3	15	2
Did other commitments affect you completing the program?	5	13	2
Did any other personal factors affect you completing the program?	3	15	2
External factors
Did the weather affect you completing the program?	4	15	1
Did transport difficulties affect you completing the program?	7	12	1
Did the program location affect you completing the program?	1	18	1
Did any other factor affect you completing the program?	0	19	1

The other commitments affecting program completion were: work (n = 3) and medical investigations (n = 2). The other personal factors affecting program completion were: hard to motivate self to leave the house (n = 2) and slow to recover after being hospitalised (n = 1).