General practitioner's referencing habits to pulmonary rehabilitation

In Portugal, only 2% of people with COPD have access to pulmonary rehabilitation (PR), but this is a worldwide problem. In Portugal, rehabilitation nurses have a key role in community PR programmes, given their specific competencies. Many factors may influence access and adherence to PR, either structural and contextual or related to patients and physicians. Given the benefits of PR on COPD, it is essential to improve its access to maintain the effects over time. Thus, we analysed the reasons for non-referral for PR by general practitioners (GP). This is an observational, descriptive and cross-sectional study recruiting GP working in a northern Portuguese urban area, and preliminary results are reported. An online questionnaire was applied, including sociodemographic variables (gender, age and academic degree) and professionals (category, length of service), as well as knowledge about benefits, criteria, barriers and referral habits for RR. In addition, frequencies and descriptive statistics will be extracted for the variable's knowledge and referral habits for RR, and the relationship between these variables and sociodemographic characteristics will be evaluated. Among 37 respondents, 13,2% (n=5) have never referred a patient to PR, and 84.8% (n=28) of those who have referred, have done it for 1 to 5 patients. In addition, some of the evidence-based benefits of PR are not identified by GPs, such as PR's effect on anxiety and depression levels, mortality, functional capacity and post-exacerbation rehabilitation. This study highlights some difficulties and barriers that GP may encounter that limit referral to PR, which could be overcome by promoting PR and its benefits among physicians.