Chapter 6 118 stable health outcomes [37]. Both healthcare providers and patients gain substantial benefits; less time and costs spent and placing the patients central to address their needs leading to improved health behaviors, health outcomes, and quality of life. Conclusions In this prospective cohort study, we developed and validated an adherence prediction model with good discrimination and calibration that can be used to estimate the probability of adherence in patients with COPD following PR for at least one month. The final predictors (intention, depression, MRC-score, and alliance) are easily to obtain in clinical practice and can be entered into a calculator to obtain prognostic estimates. These estimates can be used by healthcare providers to manage the patient instead of managing the disease, and thereby to determine the treatment frequency for each individual patient. As a result, healthcare capacity might be better distributed, potentially reducing pressure on healthcare without compromising the effectiveness of PR for the individual patient. References 1. Lozano, R., M. Naghavi, K. Foreman, et al., Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012. 380(9859): p. 2095-128. 2. Stolz, D., T. Mkorombindo, D.M. Schumann, et al., Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. The Lancet, 2022. 400(10356): p. 921-972. 3. FIRS, The global impact of respiratory disease. 2021. Available at: https://www.firsnet.org/images/publications/FIRS_Master_09202021.pdf (cited March 17, 2023. 4. Zafari, Z., S. Li, M.N. Eakin, M. Bellanger, and R.M. Reed, Projecting Long-term Health and Economic Burden of COPD in the United States. Chest, 2021. 159(4): p. 1400-1410. 5. GOLD, Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2023. Available at: https:// goldcopd.org/2023-goldreport-2/ (cited March 17, 2023). 6. Vzinfo.nl. COPD. 2022 (cited 2022 November 2022). 7. RIVM, Maatschappelijke kosten voor astma, COPD en respiratoire allergie [Social costs for asthma, COPD and respiratory allergy]. 2012. Available at: https://www.rivm.nl/bibliotheek/rapporten/260544001.pdf (cited March 17, 2023). 8. Spruit, M.A., et al., An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. Am J Respir Crit Care Med, 2013. 188(8): p. e13-e64.
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