Stakeholder engagement to understand the challenges of implementing Pulmonary Rehabilitation in Malaysia

Clinical Research Results Abstract Research Idea Abstract Service Development & Evaluation Abstract IntroductionMortality and morbidity from chronic respiratory diseases (CRDs) are increasing in low and middle-income countries (LMIC). Despite evidence of benefits of pulmonary rehabilitation (PR) for patients with CRDs especially in functional exercise capacity, dyspnoea, quality of life, hospitalisation and healthcare costs, PR services are limited in Malaysia. Stakeholder engagement can be used to constructively implement research findings leading to better patient care, health innovation and policy reform. Objectives To engage stakeholders and explore barriers, challenges, and possible solutions to the implementation of a PR programme in Malaysia, MethodsWe held a stakeholder event using virtual platform in April 2021. 110 stakeholders involving multidisciplinary team from public and private hospitals across every state in Malaysia joined the event that consisted of information sharing sessions by experts in the field of PR and breakout sessions to explore perspectives on implementing a PR programme in Malaysia. Results Organisational barriers to PR implementation included poor knowledge of PR amongst providers, lack of financial and human resources, absence of clear local guidelines and referral pathways. In addition lack of patient awareness was a barrier to their participation. Proposed solutions included formal PR training of healthcare professionals, accessible equipped facilities and clear communication pathways between healthcare sectors, produce locally appropriate evidence-based PR guidelines, organize community outreach programmes, provide better patient education and shared decision-making between healthcare professionals and patients. ConclusionThis activity has engaged stakeholders and provided an understanding of the needs of stakeholders and helped identify solutions to barriers for PR implementation in Malaysia. Declaration of Interest Funding: This research was commissioned by the UK National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE), using UK Aid from the UK Government. 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.Competing interests: EMK reports grants from the National Institute for Health Research Global Health Research Unit on Respiratory Health (RESPIRE) and Seqirus UK; personal fees from AstraZeneca and GlaxoSmithKline; and is board director of the International Primary Care Respiratory Group. The authors have completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author), and declare no further conflicts of interest. References and Clinical Trial Registry Information