Perceptions of patients about Pulmonary Rehabilitation in Bangladesh

Clinical Research Results Abstract Background and aim: Pulmonary rehabilitation (PR) is an integral part of chronic respiratory diseases (CRDs) care. However, PR services are new to most patients in Bangladesh. We, therefore, aimed to assess the perceptions of patients about their respiratory condition, about PR as a part of disease management, and to identify challenges and facilitators to implementing PR in Bangladesh. Method: We conducted qualitative interviews with 15 people living with CRDs who had participated in the PR feasibility pilot. We used purposive sampling to capture a broad range of perspectives about common CRDs in Bangladesh and used a grounded theory approach to analyse our findings. Result: Ten male and five female patients with COPD, post-TB, asthma, bronchiectasis, or interstitial lung disease were interviewed. Acceptability and attending the supervised exercise session were the major concerns. Three major themes emerged. Understanding of disease by the patients was symptom-based and disappearance of symptoms was considered to represent ‘cure’ of the disease. Their perception was of PR varied. Some were surprised with being offered an exercise programme that triggered breathlessness (the symptom they were trying to cure). Others believed exercise was good for diseases (e.g., diabetes) but not for treating their symptoms. Hearing about the benefits of PR from other patients helped overcome this barrier. Regarding the implementation of PR, their views reflected the context of Bangladesh. Most patients were concerned about the acceptability, affordability, and availability of the service. To overcome these challenges, they suggested a massive awareness programme, individual motivation in discussion with their clinician, and making the service easy to access and affordable. Conclusion: The patient’s understanding of CRD is different from that of the bio-medical definition. This in-depth understanding of patients views on their disease and perceptions of a new intervention will inform strategies to implement PR in Bangladesh. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest References and Clinical Trial Registry Information