Predictors of Outpatient Pulmonary Rehabilitation Uptake, Adherence, Completion, and Treatment Response Among Male U.S. Veterans With Chronic Obstructive Pulmonary Disease.

The study was done at one VA Boston center and included only male veterans with limited racial and ethnic diversity, so it may not apply to women, civilians, or more diverse populations. It was a retrospective chart review of routine care, not a randomized trial, so it cannot show that cancer history, smoking, alcohol use disorder, breathlessness, or self-efficacy caused pulmonary rehabilitation completion or treatment response. Missing data ranged from 0.9% to 18.8% among completers, and multiple imputation was used. Reasons for never starting or dropping out were collected with one open-ended telephone question by scheduling staff, so they may not capture all barriers. The sample size may have been too small to detect differences between never starters, dropouts, and completers. The authors did not examine predictors of mastery response beyond baseline mastery.

The supplied publication types indicate U.S. government research support, but the text gives no author conflict-of-interest declaration.

Do not read the 35.9% of completers meeting the 30-meter walking improvement as proof that pulmonary rehabilitation caused that gain. The study looked back at routine records rather than assigning treatment, and the authors state that the results do not establish causality.