Article

PURPOSE: To evaluate adherence to a maintenance exercise program in patients with
chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. METHODS: Seventy patients with COPD were referred to a home-care
maintenance exercise program after completing pulmonary rehabilitation (PR) in
the rehabilitation center. Adherence (yes/no) to the maintenance program was
assessed by a self-reported questionnaire, where adherence was defined as
attending the maintenance program 1 year after PR. Early dropouts received a
self-reported questionnaire after 6 months and the remaining patients after 12
months. Lung function, exercise capacity, exercise self-efficacy, illness
perceptions, health-related quality of life, levels of anxiety and depression,
duration of PR, and the number of exacerbations were studied as possible
predictors of adherence. RESULTS: Ten patients died or were lost to followup. Of
the remaining 60 patients, 73.3% and 63.3% were adherent to the maintenance
exercise program after 6 and 12 months, respectively. Forced expiratory volume in
1 second (FEV1) (P = .021), Hospital Anxiety and Depression Scale depression
score (P = .025), and duration of PR (P = .018) were significant predictors of
adherence to the maintenance program. CONCLUSION: Adherence to the maintenance
exercise program included a 36.7% drop-out rate during the first year after
completing PR. Experiencing exacerbations was the most reported reason for
dropout. Poorer lung function, shorter initial PR course measured by reviewing
patient records, and higher level of depressive symptoms were predictive of
drop-out to the maintenance program. Adherence to the maintenance program needs
to be improved for patients with lower FEV1, with signs of depression, or with a
shorter initial PR course.

Langue : ANGLAIS