Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis

Summary Introduction Pulmonary Rehabilitation (PR) reduces hospital admissions following an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) but adherence is known to be poor. Patients' illness perceptions may affect adherence to disease-management strategies but to date have not been explored following an exacerbation. The study aim is two-fold; firstly to prospectively explore acceptance and uptake of post-exacerbation PR and secondly to identify possible clusters of patients' illness perceptions following hospitalisation for an exacerbation of COPD. Methods Patients admitted to hospital with an exacerbation of COPD were recruited to a prospective observational study. Self-reported illness perceptions, mood, health status and self-efficacy were assessed. Acceptance and uptake of PR were recorded at six months. Cluster analysis of Illness Perceptions Questionnaire-Revised data was used to establish groups of patients holding distinct beliefs. Results 128 patients were recruited. Acceptance and uptake of PR following an acute exacerbation was poor with only 9% ( n = 11) completing the programme. Cluster analysis revealed three distinct groups: Cluster 1 ‘in control’ ( n = 52), Cluster 2 ‘disengaged’ ( n = 36) and Cluster 3 ‘distressed’ ( n = 40). Significant between-cluster differences were observed in mood, health status and self-efficacy ( p