Chapter 5 86 is important, because it may contribute to developing tailored health services to realize more affordable health care [11]. Although adherence to prescribed exercise has been described in studies in patients with COPD, the definition of adherence, units of measurement, and data analysis strategies vary considerably [12]. Validated measurements are hardly used [13]. Many studies used self-reports and logs [12] and some used pedometers [14]. Therefore, it is hard to deduce what the common course of adherence to COPD self-management exercises is over time. The aim of this study was to determine the course of adherence to exercise over a 12-month period in patients with COPD receiving prolonged pulmonary rehabilitation in primary physiotherapy practices in the Netherlands and Belgium. Materials and methods Methods comply with the Strengthening The Reporting of Observational Studies in Epidemiology (STROBE) checklist for cohort studies. Design and routing Participants of this prospective cohort study were Dutch/Flemish-speaking patients aged ³ 18 years from primary physiotherapy practices, and from the COPD patientorganizations from the Netherlands and Belgium. Recruitment commenced in January 2021, and 12-month follow-up assessments were completed in August 2022. Physiotherapy practices were approached by email and social media for participation and patients were recruited by their attending physiotherapist. Patients who were willing to participate were contacted by the researcher per email for further information on their participation, and to obtain informed consent. For patients without an e-mail address, this was done by their physiotherapist during their visit to the physiotherapy practice. Patients were also recruited via the COPD patient-organization in the Netherlands and Belgium who, in turn, invited their physiotherapists for participation. A detailed description of the recruitment process is described elsewhere [15]. The study was approved by the Ethical Committee Psychology of the University of Groningen (PSY-1920-S-0504). Participants Patients (³ 18 years) with COPD, with airflow limitation stage GOLD II-IV, and having rehabilitation sessions for at least once a month, for at least one month, were potentially eligible for inclusion. The exclusion criteria were home-based rehabilitation, and insufficient mastery of the Dutch/Flemish language to complete the questionnaires.
RkJQdWJsaXNoZXIy MjY0ODMw