ArticleChest2025
The Frequency and Predictors of Pulmonary Rehabilitation Referrals Among Patients With Pulmonary Arterial Hypertension: An Analysis of the Pulmonary Hypertension Association Registry.
Article in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
19 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary arterial hypertension (PAH) is a complex cardiopulmonary disease associated with exertional dyspnea and impaired health-related quality of life (HRQOL) despite medical therapy. Pulmonary rehabilitation (PR), a supervised exercise program for patients with chronic lung disease, improves symptoms, HRQOL, and exercise capacity. Despite these benefits, there is a paucity of data regarding PR in PAH. RESEARCH QUESTION: What is the frequency of PR referrals among patients with PAH, and what factors are associated with PR referrals? STUDY DESIGN AND
methodsWe performed a retrospective cohort study of adults with PAH enrolled in the Pulmonary Hypertension Association Registry. Patients referred to PR by the time of the second follow-up visit were compared with patients never referred to PR.
resultsPR referral rates were 17.0%, 26.6%, and 32.3% at the first, second, and third follow-up visits, respectively. Patients referred to PR were older (58.3 ± 15.3 vs 55.2 ± 15.6; P < .001), more likely to be female (81.9% vs 75.9%; P = .02), and exhibited differences in race, geographic region, employment status, and PAH etiology. Referred patients had worse functional class, risk stratification, HRQOL, and 6-minute walk distance with higher rates of supplemental oxygen use and similar pulmonary hemodynamics and use of PAH therapy. In multivariable analysis, race, region, and PAH etiology and disease severity as assessed by REVEAL Lite 2.0 scores, supplemental oxygen use, and lung transplantation referral were independently associated with PR referral. In a subgroup analysis, less than one-half of patients referred to PR reported participation in PR within the preceding 6 months. PR participation, but not PR referrals, was associated with improvements in HRQOL.
interpretationDespite well-established benefits, this study indicates that referral to PR is low among patients with PAH and is significantly impacted by demographic and socioeconomic factors as well as disease characteristics.
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