Formulating and testing a strategy for introducing Pulmonary Rehabilitation for COPD management in a rural Indian setting

1. Research question:What are the perceptions of individuals diagnosed with COPD and healthcare providers about need for Pulmonary Rehabilitation (PR) in rural Pune District? Can a PR service be designed and implemented in rural Pune District? 2. Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD), recommends that PR should be a part of integrated patient management. PR is an effective strategy to improve shortness of breath, health status and exercise tolerance. To address the inadequate knowledge and practice of PR in rural areas of Pune district, we need to develop a service tailored to the local setting.3. Possible Methodology:A three-stage methodology including an initial needs assessment, informing the design of a locally-adapted PR service for piloting through a two-tiered PR centre.Work-Package 1: Conduct a PR needs assessment in a rural community setting from caregiver and recipient’s perspective.Stakeholders: COPD-diagnosed patients as primary participants, their family members, health-caregivers and programme managers. Work-package 2: Design a PR strategy for COPD management in rural Indian settings.Adaptation of PR guidelines: PR as described by the European Respiratory Society will be adapted based on findings of the needs assessment. Along with exercise training, education and physical therapy are important components of PR. A Technical Advisory Group (TAG) will be formed comprising pulmonologists, stakeholders, physiotherapists and counsellorsWork-package 3: Testing and implementation of the formulated strategy for COPD management in rural Indian setting.A comprehensive intervention will be conducted using Behaviour Change Communication (BCC) 4. Question to discuss: Which components of PR can we implement/adapt for our rural setting? What follow-up of patients after PR will help sustainability? What is the applicability of PR to other chronic respiratory disorders (e.g. Post Tuberculosis lung disorders?) Declaration of Interest All the authors declare that there is no conflict of interest.This project is funded by NIHR Global Health Research Unit on Respiratory Health (RESPIRE) 16/136/109 References and Clinical Trial Registry Information References:1. ATS/ERS Task force on Pulmonary Rehabilitation. ERJ 2016; 47:1336-412. Sharma et al. Pulmonary Rehabilitation: An overview. Lung India 2011;276-284