Pulmonary rehabilitation (PR) is a recommended standard of care for patients with chronic obstructive pulmonary disease (COPD), as it improves exercise capacity and health-related quality of life (HRQOL), attenuates perceived dyspnoea, and decreases the need for hospitalisation. The objective of this study was to compare medical and sociodemographic characteristics of COPD patients who were enrolled and completed the PR with those of COPD patients who were resident in the same municipality but were not enrolled into this PR. The data used for comparison came from the Danish National Registers. The COPD patients who were enrolled and completed the rehabilitation differed from COPD patients who were not enrolled into the rehabilitation in the following: (1) there were more women than men among those who were enrolled; (2) those who were enrolled had higher socioeconomic status compared to those who were not enrolled; and (3) those who were enrolled into the rehabilitation used more COPD-specific medication compared to those who were not enrolled. In conclusion, to enrol more COPD patients into PR, special attention needs to be paid to COPD patients from lower socioeconomic status groups as well as male patients. 1. Introduction Chronic obstructive pulmonary disease (COPD) is a disease that clinically manifests itself by gradual physical impairment, increasing breathlessness, and episodes of acute exacerbations which deteriorate overall health and require hospitalisation. Morbidity and mortality related to COPD is increasing [1]. COPD is especially frequent in Denmark. According to the calculations done by the Copenhagen City Heart Study in 2010, an overall prevalence of COPD in Denmark was 17.4% among individuals of 35 years of age or older, while estimated COPD prevalence from studies in other developed countries ranged from 5% to 19% with the majority being in the vicinity of 10% [2]. In the Capital Region of Denmark, the prevalence of COPD among individuals older than 40 years old of age is 15% corresponding to 120,000 citizens. Among those, more than 19,000 meet the criteria for a rehabilitation programme, that is, forced expiratory volume during one second (FEV1) being less than 80% of predicted value, and dyspnea scoring 3 or higher on the Medical Research Council (MRC) scale [3]. Pulmonary rehabilitation (PR) is a recommended standard of care for patients with COPD. According to the definitions set by the American Thoracic Society and the European Respiratory Society, comprehensive PR programmes should include patient assessment, exercise training,
References
[1]
WHO, “World Health Report 2000,” http://www.who.int/whr/2000/en/.
[2]
P. Fabricius, A. L？kke, J. L. Marott, J. Vestbo, and P. Lange, “Prevalence of COPD in Copenhagen,” Respiratory Medicine, vol. 105, no. 3, pp. 410–417, 2011.
[3]
P. Lange, J. L. Marott, M. Dahl, T. S. Ingebrigtsen, J. Vestbo, and B. G. Nordestgaard, “Substantial need for early diagnosis, rehabilitation and treatment of chronic obstructive pulmonary disease,” Danish Medical Journal, vol. 59, no. 4, Article ID A4396, 2012.
[4]
L. Nici, C. Donner, E. Wouters et al., “American thoracic society/European respiratory society statement on pulmonary rehabilitation,” American Journal of Respiratory and Critical Care Medicine, vol. 173, no. 12, pp. 1390–1413, 2006.
[5]
A. L. Ries, G. S. Bauldoff, B. W. Carlin et al., “Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines,” Chest, vol. 131, no. 5, pp. 4S–42S, 2007.
[6]
Y. Lacasse, R. Goldstein, T. J. Lasserson, and S. Martin, “Pulmonary rehabilitation for chronic obstructive pulmonary disease,” Cochrane Database of Systematic Reviews, no. 4, Article ID CD003793, 2006.
[7]
B. Bjoernshave, J. Korsgaard, C. Jensen, and N. C. Vinther, “Participation in pulmonary rehabilitation in routine clinical practice,” The Clinical Respiratory Journal, vol. 5, no. 4, pp. 235–244, 2011.
[8]
E. Borg, J. Egsgaard, A. Fr？lich et al., Sammenh？ngende Indsats for Kronisk Syge. Evaluering af et samarbejdsprojekt mellem Bispebjerg Hospital, Sundheds- og Omsorgsforvaltningen, K？benhavns Kommune og praktiserende l？ger p？ ？sterbro, Klinisk Enhed for Sygdomsforebyggelse, Bispebjerg Hospital, Region Hovedstaden & Sundheds- og Omsorgsforvaltningen, K？benhavns Kommune, K？benhavn, 2008.
[9]
A. Frolich, D. Host, H. Schnor et al., “Integration of healthcare rehabilitation in chronic conditions,” International Journal of Integrated Care, vol. 10, Article ID e1033, 2010.
[10]
R. Jacobsen, A. Frolich, and N. S. Godtfredsen, “Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 32, no. 2, pp. 92–100, 2012.
[11]
A. H. Davis, “Exercise adherence in patients with chronic obstructive pulmonary disease: an exploration of motivation and goals,” Rehabilitation Nursing, vol. 32, no. 3, pp. 104–110, 2007.
[12]
E. Lahelma, P. Martikainen, M. Laaksonen, and A. Aittom？ki, “Pathways between socioeconomic determinants of health,” Journal of Epidemiology and Community Health, vol. 58, no. 4, pp. 327–332, 2004.
[13]
K. Kommune, “Hustande efter hustandstype og indkomst,” http://www.kk.dk/statistik.
[14]
WHO, Closing the Gap in A Generation. Health Equity through Action on the social Determinants of Health, World Health Organization, Geneva, Switzerland, 2008.
[15]
E. Prescott, N. Godtfredsen, J. Vestbo, and M. Osler, “Social position and mortality from respiratory diseases in males and females,” European Respiratory Journal, vol. 21, no. 5, pp. 821–826, 2003.
[16]
E. Prescott, P. Lange, and J. Vestbo, “Socioeconomic status, lung function and admission to hospital for COPD: results from the Copenhagen City Heart Study,” European Respiratory Journal, vol. 13, no. 5, pp. 1109–1114, 1999.
[17]
R. M. Andersen, “Revisiting the behavioral model and access to medical care: does it matter?” Journal of Health and Social Behavior, vol. 36, no. 1, pp. 1–10, 1995.
