Quantifying uptake and completion of pulmonary rehabilitation programs in people with COPD known to tertiary care

Pulmonary rehabilitation programs (PRPs) are important for people with symptomatic chronic obstructive pulmonary disease (COPD), but program attrition is common. Among people with COPD who appeared appropriate for a PRP, we prospectively mapped the rehabilitation journey, captured attrition and explored factors influencing attendance to pre-program assessment. 391 participants consented, of which 123 (31% [95% confidence interval {CI}] 27 to 36) were referred to a PRP (mean±SD or frequency[%]: age 68±10yr, 62 males[50%], BMI 27±8kg/m 2 , FEV 1 45±19%predicted). Of those referred, 94 (76% [69 to 84]) attended a pre-program assessment. Ex-smokers (odds ratio [95%CI]; 2.6 [1.1 to 6.1]) and those who had a healthcare professional explain they would be referred (4.7 [1.9 to 11.7]) were more likely to attend a pre-program assessment. Of those who attended, 63 (67% [58 to 77]) commenced and 35 (56% [43 to 68]) completed a PRP. Substantial attrition occurs throughout the PRP journey. Understanding how HCPs can best contextualise PRPs to encourage uptake is an important area for further work.