Formulating and testing a strategy for introducing PR for COPD management in a rural Indian setting.

05 May 2022
Clinical Research Results Abstract Introduction: PR is proven to be the most effective strategy to improve shortness of breath, health status & exercise tolerance as well as reduce readmissions and mortality in recent exacerbations patients. There is no therapeutic or rehabilitative government health program for COPD management. Most of the PR centres are in the urban area &studies are rarely done in the rural population to understand the feasibility of PR. We aimed to formulate and test a PR strategy by assessing the need for PR from the perspective of people with COPD & HCP in a rural Indian setting.Methods: WP1: A semi-structured questionnaire was administered on HCPs (locally practicing GPs and MOs) (n=09) and the patients suffering from COPD (n=14) to understand their perspectives and their perceptions about the need for Pulmonary Rehabilitation.WP2: We designed a PR strategy after conducting multiple discussions with the technical advisory group (TAG) for COPD management using the findings from WP1 and PR as described by the ERS in rural Indian settings.WP3: We systematically tested the feasibility & clinical benefits of introducing PR for individuals diagnosed with COPD (n=46). Results: WP1- Patients with COPD and HCPs showed low awareness. Most patients expressed willingness and need for PR after education was provided. Positive response was received about performing home based exercises. There is no PR service in the village and the doctors refer them to the city areas. Cost of such services play a major role in the feasibility of such services.WP3- 10 participants completed the 12 week PR program and showed a significant improvement in their exercise capacity, quality of life and psychological health and reduce hospital admissions. Conclusion: The study met the aim of generating findings to be incorporated into the formulation of a PR strategy to be implemented and further showcased feasibility in a rural Indian setting. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest References and Clinical Trial Registry Information References 1 Habib, G. M., Uzzaman, M. N., Malik, P., Rabinovich, R., Uddin, A., Alam, S. R., Williams, S., & Pinnock, H. (2020). Engaging with stakeholders in a research programme to promote implementation of pulmonary rehabilitation in Bangladesh: Challenges and opportunities. Journal of Global Health, 10(2), 1–6. https://doi.org/10.7189/JOGH.10.0203842 Kendall, M., Buckingham, S., Ferguson, S., MacNee, W., Sheikh, A., White, P., Worth, A., Boyd, K., Murray, S. A., & Pinnock, H. (2018). Exploring the concept of need in people with very severe chronic obstructive pulmonary disease: a qualitative study. BMJ Supportive & Palliative Care, 8(4), 468–474. https://doi.org/10.1136/bmjspcare-2015-000904 3 Ma, P., Cj, et al (2007). Pulmonary rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest, 131(12), 4S-42S. https://doi.org/10.1002/14651858.CD005305.pub4.www.cochranelibrary.com 4 O’Connor, et al, G. H. (2019). Is inspiratory muscle training (IMT) an acceptable treatment option for people with chronic obstructive pulmonary disease (COPD) who have declined pulmonary rehabilitation (PR) and can IMT enhance PR uptake? A single-group pre post feasibility study in a h. BMJ Open, 9(8), 1–12. https://doi.org/10.1136/bmjopen-2018-028507 5. Salvi S. COPD: The neglected epidemic. Textbook of Pulmonary and Critical Care Med Vol 2, Ed: Jindal SK, Jaypee Publications, 2011;971-974.

Resource information

Respiratory conditions
  • COPD
Type of resource
Abstract
Conference
Malaga 2022
Author(s)
Diksha Singh, KEM Hospital Research Centre