title: Participation in pulmonary rehabilitation in routine clinical practice.
abstract: OBJECTIVE
  Denmark offers COPD rehabilitation to enable patients to tackle the consequences of COPD, but only a minority of the patients complete these programs. To increase the completion rate, an follow-up study was performed, to characterize COPD patients and to identify potential differences between those who complete and those who do not complete rehabilitation or do not even get a rehabilitation offer in daily clinical routine.
  
  
  METHODS
  In- and out COPD-patients who participated in baseline tests were compared in terms of completion of rehabilitation, drop-out, and no rehabilitation offer. We obtained data on basic characteristics, co-morbidity, lung-function (FEV1), dyspnea (MRC), six-minute walkg-distance (6MWD), and quality of life (SF36).
  
  
  RESULTS
  The source population counted 521 COPD patients of whom 256 were excluded (diagnosis withdrawn, death, moved away, long-term oxygen, severe illness). Patients who completed rehabilitation had a 15% longer 6MWD than patients not offered rehabilitation and a 10% longer 6MWD than drop-outs despite a significant lower subjective perception of physical function among completers than in the two other groups. Patients not offered rehabilitation had a slightly better lung function than the other two groups. This suggests that lower physical performance with the same (drop-outs) or even higher (not offered) lung function indicates a lower chance of completion.
  
  
  CONCLUSIONS
  COPD patients who could potentially benefit most from completing rehabilitation seem to be deselected. A mere 9% completed rehabilitation within the study period and 23% ever completed. This demonstrates that the political target that 60% of COPD patients should be offered rehabilitation is still far away.
authors.affiliation: Medical Department, Horsens Regional Hospital and Department of Clinical Social Medicine and Rehabilitation, Institute of Public Health, Aarhus University, Denmark. bodil.bjoernshave@stab.rm.dk
authors.forename: Bodil
authors.initials: B
authors.lastname: Bjoernshave
authors.forename: Jens
authors.initials: J
authors.lastname: Korsgaard
authors.forename: Chris
authors.initials: C
authors.lastname: Jensen
authors.forename: Claus
authors.initials: C
authors.lastname: Vinther Nielsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D017079:Exercise Tolerance; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests