Exploring the value of a community-based physical activity (PA) intervention for COPD patients with varying needs in Brazil

Clinical Research Results Abstract INTRODUCTION: Physical activity (PA), as part of COPD treatment, improves dyspnea, psychological wellbeing, quality of life and reduces the risk of exacerbation. However, many people with COPD fear and do not engage with PA, this may be worse in those with anxiety and depression.METHODS: We purposively sampled people with COPD in São Paulo, Brazil who had responded to a questionnaire including the GAD-7 and PHQ9. Participants were selected to represent those with and without emotional disorders, a range of age groups, gender, time from COPD diagnosis and from primary and specialised care. Semi-structured telephone interviews between October 2020 to April 2021 explored COPD knowledge, perceptions of barriers and facilitators to PA and views on community PA service provision. Discussions were audio-recorded, transcribed and analysed using the Framework method.RESULTS: 21 patients participated. Five themes were identified. 1) Knowledge about COPD and its management - COPD was generally viewed as a neglected disease dependent on specialist services. 2) Living with COPD – COPD reduced quality of life. 3) Knowledge and experience of emotional disorders – participants showed insight into their emotional status. 4) Views on PA - all viewed PA as important and were generally enthusiastic for provision of community PA programmes. Those who had participated in exercise as part of pulmonary rehabilitation (PR) described improvements in symptoms and wellbeing. People with emotional disorders tended to view PA more negatively and anxiety was a reported barrier to smoking cessation. 5) Impact of COVID-19 - COVID-19 had reduced PA opportunities, access to COPD treatment and social interaction, and participants experienced more exacerbations and emotional difficulties.DISCUSSION: There is room for improvement in the level of care offered to patients and their families, including encouraging PA, facilitating access to PR and collaborating with the multi-disciplinary team. COVID-19 has had a negative impact. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest The authors declare no conflicts of interest. This research was funded by the National Institute for Health Research (NIHR) NIHR global group on global COPD in primary care, University of Birmingham, (project reference: 16/137/95) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care. References and Clinical Trial Registry Information