Facilitators and Barriers to Uptake and Complete Pulmonary Rehabilitation for Patients With
COPD
: A Mixed Method Systematic Review
Thea Rebecca Eigestad, Kurt Hatløy, Heidi Øksnes Markussen ABSTRACT
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