Community lung health service design for COPD patients in China by the Breathe Well group

19 Aug 2022
Respiratory conditions
  • COPD
Type of resource
Peer-reviewed article
  • Breathe Well
Hui Pang # 1 2, Zihan Pan # 3 4, Rachel Adams 5, Eleanor Duncan 6, Chunhua Chi 7, Xia Kong 1, Peymané Adab 6, Kar Keung Cheng 6, Brendan G Cooper 8, Jaime Correia-de-Sousa 9 10, Andrew P Dickens 6, Alexandra Enocson 6, Amanda Farley 6, Nicola Gale 6, Kate Jolly 6, Sue Jowett 6, Mariam Maglakelidze 11 12, Tamaz Maghlakelidze 11 13, Sonia Martins 14, Alice Sitch 6 15, Katarina Stavrik 16, Raphael Stelmach 17, Alice Turner 6 18, Siân Williams 9, Rachel E Jordan 6 Affiliations 1Department of General Practice, Peking University First Hospital, 100034, Beijing, China. 2Department of Emergency, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China. 3Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, China. 4Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China. 5Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK. 6Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK. 7Department of General Practice, Peking University First Hospital, 100034, Beijing, China. 8Lung Function & Sleep, Queen Elizabeth Hospital, B15 2WB, Birmingham, UK. 9International Primary Care Respiratory Group, Aberdeenshire, UK. 10Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal. ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal. 11Georgian Respiratory Association, Tbilisi, Georgia. 12Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia. 13Ivane Javakhisvhili Tbilisi State University, Tbilisi, Georgia. 14Family Medicine, ABC Medical School, Sao Paulo, Brazil. 15NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK. 16Center for Family Medicine, Faculty of Medicine, Ss.Cyril and Methodius University in Skopje, Skopje, North Macedonia. 17Faculty of Medicine, University of São Paulo, São Paulo, Brazil. 18Institute of Inflammation and Ageing, University of Birmingham, B15 2TT, Birmingham, UK. #Contributed equally.


COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients' and general practitioners' (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire; 39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients' lack of knowledge/understanding of COPD, current management of COPD not meeting patients' needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients' needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.