ArticleCOPD2017
Social Determinants of Adherence to Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease.
Article in COPD, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Equity in pulmonary rehabilitation delivery: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Barriers and facilitators to pulmonary rehabilitation in COPD: a mixed-methods systematic review.BMC pulmonary medicine · 2025Pooled it
- Supportive eHealth Technologies and Their Effects on Physical Functioning and Quality of Life for People With Lung Cancer: Systematic Review.Journal of medical Internet research · 2024Pooled it
- Effects of Home-Based Training with Internet Telehealth Guidance in COPD Patients Entering Pulmonary Rehabilitation: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2023Pooled it
- Effectiveness comparison of inpatient vs. outpatient pulmonary rehabilitation: a systematic review.BMC health services research · 2022Pooled it
- Feasibility of a Health Coaching and Home-Based Rehabilitation Intervention With Remote Monitoring for COPD.Respiratory care · 2021Trial
- Reframing Rehabilitation Retention in Long-Term Conditions: A Theory-Informed Mini-Review of Psychological Adaptation and Engagement.Healthcare (Basel, Switzerland) · 2026Review
- Wearable Sleep Measures May Improve Machine Learning Prediction of Home-Based Pulmonary Rehabilitation Engagement Among Patients With Chronic Obstructive Pulmonary Disease: A Proof-of-Concept Study.Mayo Clinic proceedings. Digital health · 2026Article
- Singing for adults with chronic respiratory disease.The Cochrane database of systematic reviews · 2026Article
- Article
- Using wearable and nearable devices in telerehabilitation for COPD: a scoping review of digital endpoints in home-based programs.Frontiers in digital health · 2026Review
- Patient Characteristics and Outcomes by Sex and Smoking Status in Pulmonary and Cardiac Rehabilitation.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Rehabilitation for Physical Frailty in Lung Transplant Candidates: A Systematic Review.Cardiopulmonary physical therapy journal · 2025Article
- Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention.BMC digital health · 2025Article
- Neighborhood Socioeconomic Deprivation and Health Care Costs in Older Community-Dwelling Adults: Importance of Functional Impairment and Frailty.Journal of general internal medicine · 2024Article
- Barriers to Pulmonary Rehabilitation.Respiratory care · 2024Article
- Differences in up-to-date colorectal and cervical cancer screening rates by ethnicity and preferred language: An analysis across patient-, clinic-, and area-level data sources.SSM - population health · 2024Article
- Current Landscape and Future Directions of Patient Education in Adults with Interstitial Lung Disease.ATS scholar · 2024Review
- Compliance and rehabilitation effects of Zheng's supine rehabilitation exercise performed at home among patients with chronic obstructive pulmonary disease: a retrospective study.Journal of thoracic disease · 2023Article
- Pulmonary rehabilitation assessment in COPD based on the ICF brief core set: a latent profile analysis.Annals of medicine · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. We aimed to identify social determinants of adherence to PR. A cross-sectional analysis of a database of COPD patients (N = 455) in an outpatient PR program was performed. Adherence, a ratio of attended-to-prescribed sessions, was coded as low (<35%), moderate (35-85%), and high (>85%). Individual-level measures included age, sex, race, BMI, smoking status, pack-years, baseline 6-minute walk distance (6MWD: <150, 150-249, ≥250), co-morbidities, depression, and prescribed PR sessions (≤20, 21-30, >30). Fifteen area-level measures aggregated to Census tracts were obtained from the U.S. Census after geocoding patients' addresses. Using exploratory factor analysis, a neighborhood socioeconomic disadvantage index was constructed, which included variables with factor loading >0.5: poverty, public assistance, households without vehicles, cost burden, unemployment, and minority population. Multivariate regression models were adjusted for clustering on Census tracts. Twenty-six percent of patients had low adherence, 23% were moderately adherent, 51% were highly adherent. In the best fitted full model, each decile increase in neighborhood socioeconomic disadvantage increased the risk of moderate vs high adherence by 14% (p < 0.01). Smoking tripled the relative risk of low adherence (p < 0.01), while each increase in 6MWD category decreased that risk by 72% (p < 0.01) and 84% (p < 0.001), respectively. These findings show that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.