scholarly journals Exploring transitions in care from pulmonary rehabilitation to home for persons with chronic obstructive pulmonary disease: A descriptive qualitative study

2020 ◽  
Vol 23 (2) ◽  
pp. 414-422
Author(s):  
Jonathan Miranda ◽  
Danielle Underwood ◽  
Miranda Kuepfer‐Thomas ◽  
Drew Coulson ◽  
Andy Chansoo Park ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Qualitative Study ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Transitions In Care ◽  
Descriptive Qualitative

scholarly journals Referral of patients with chronic obstructive pulmonary disease to pulmonary rehabilitation: a qualitative study of barriers and enablers for primary healthcare practitioners

2020 ◽  
Vol 70 (693) ◽  
pp. e274-e284 ◽  
Author(s):  
Jane S Watson ◽  
Peymane Adab ◽  
Rachel E Jordan ◽  
Alexandra Enocson ◽  
Sheila Greenfield
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Qualitative Study ◽  
Pulmonary Disease ◽  
Primary Healthcare ◽  
Pulmonary Rehabilitation ◽  
Financial Incentives ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Barriers And Enablers ◽  
Clinical Benefits

BackgroundPulmonary rehabilitation (PR) is a cost-effective, internationally recommended intervention for patients with chronic obstructive pulmonary disease (COPD). Referral is predominately led by primary healthcare practitioners (PHCPs), but referral and patient uptake is poor.AimTo understand barriers and enablers for PHCPs when considering patient referral to PR, to explore the influence of patient characteristics, and to understand how referral rates may be increased.Design and settingPHCPs who care for and refer patients with COPD to PR were purposively selected from general practices across Cambridgeshire and Peterborough, and the West Midlands.MethodA qualitative study. Semi-structured interviews were undertaken to theme saturation, exploring PR referral. Images depicting patients with varying COPD severity were used to stimulate memory and associative recall. Interviews were recorded, transcribed verbatim, and analysed using rapid qualitative analysis.ResultsA total of 19 PHCPs were interviewed. Barriers to PR referral included limited awareness of the clinical benefits, little knowledge of local PR providers, consultation time constraints, and presumed low patient motivation. While practice nurses had the greatest knowledge, they still described difficulty in promoting PR. PHCPs frequently described assessing patient suitability based on presumed accessibility, social, and disease-specific characteristics rather than the clinical benefits of PR. Referrals were facilitated by financial incentives for the practice and positive feedback from patients and providers.ConclusionThere were more barriers to PR referral than enablers. Providers must engage better with PHCPs, patients with COPD, and carers, and actively promote PR. Increasing PHCPs’ awareness of the benefits of PR, financial incentives, and alternative referral pathways should be considered.

scholarly journals Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043377
Author(s):  
Kai Zhu ◽  
Jagdeep Gill ◽  
Ashley Kirkham ◽  
Joel Chen ◽  
Amy Ellis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Safety And Efficacy

IntroductionPulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.Methods and analysisMedical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.Ethics and disseminationAECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.

Sign in / Sign up

Export Citation Format

Share Document