Facilitators and Barriers to Uptake and Complete Pulmonary Rehabilitation for Patients With COPD: A Mixed Method Systematic Review.

AIM(S) To summarize, appraise and synthesis available research studies that employ qualitative, quantitative and mixed methods approaches to gain knowledge on factors and experiences that influence uptake and completion of pulmonary rehabilitation (PR) in patients with copd.

Design

Mixed method systematic review.

Methods

Joanna Briggs Institute convergent integrated approach. Mixed Method Assessment Tool used for critical appraisal. Quantitative data were transformed into qualitized data and integrated with qualitative data using reflexive thematic analysis by Braun & Clarke. Registered in PROSPERO. DATA SOURCES Embase, PubMed, Epistemonikos, Cochrane and Cinahl. Main search: 4th March 2024, updated medio January 2025.

Results

Included 28 studies (21 quantitative, 6 qualitative, 1 mixed methods). Four identified themes: patient characteristics and considerations, nurse-related factors, organizational determinants and individual variables, both in uptake and completion.

Conclusion

Highlights facilitators and barriers in several levels influencing PR uptake and completion for copd patients. Patient characteristics, the disease itself and individual variables hinder PR participation. Skilled nurses and healthcare professionals (HCPs) play a crucial role in facilitating and communicating the benefits of PR. Findings suggest action statements to help nurses/HCP overcome barriers to increase participation in PR. IMPLICATIONS FOR PROFESSION Nurses should use their expertise to guide patients and reduce barriers. The study provides insight on how PR should be planned and tailored. Future research should investigate the impact of these measures to increase participation in PR. REPORTING

Method

PRISMA (2020) checklist from EQUATOR network. PATIENT OR PUBLIC CONTRIBUTION None. TRIAL REGISTRATION The study was registered with PROSPERO. Identification number: CRD42025620484.