Healthcare professionals (HCPs) attitudes towards referring patients to pulmonary rehabilitation (PR); a cross sectional exploratory survey

Background: PR is a highly effective treatment for many lung diseases that is underutilised in the UK; only 15% of eligible chronic obstructive pulmonary disease patients have undergone a programme (Steiner et al. 2016). Aim: to explore HCPs’ attitudes towards referring patients to PR. Method: this cross sectional exploratory study used a previously piloted web based questionnaire. Purposive sampling of HCPs within the referral area of a London PR service was undertaken; 238 HCPs were invited to participate via email. Results: there was a 7% (n=16) response rate from various HCPs (GPs, nurses, respiratory consultants and physiotherapists). 100% agreed or strongly agreed that “the PR service is of use to my patients”. However their confidence in the ability to explain the structure of a PR programme to their patients was varied, with half reporting a confidence score of ≤ 5/10. When asked to explain the content of PR, 81% included information on exercise, 38% disease education and 19% symptom management. Nearly all participants identified the primary benefits of PR as an increase in patient self-belief and efficacy (n=15) and decreased breathlessness (n=14). Most HCPs either agreed or strongly agreed that that they can describe PR in a way to overcome individuals9 barriers to exercise (n=12) and that their patients were aware of how PR can improve their symptoms (n=11). Discussion: all surveyed HCPs agreed that PR is beneficial. However not all were confident to describe PR to their patients, despite 11/16 having undergone specialist respiratory training. This highlights the importance of PR being included within all specialist respiratory training.