Abstract

Background: Pulmonary Rehabilitation (PR) is an effective strategy to improve breathlessness, health status and exercise tolerance and to reduce readmissions and mortality. In India, there is no government health program for COPD management while in private sector availability of PR is limited. Most PR centres are in urban areas, with few services accessible to rural populations. We aimed to assess the need for PR from the perspective of COPD patients and healthcare professionals (HCPs: registered medical practitioners and medical officers) in rural Maharashtra. Methods: Between Jun and Oct 2020, we conducted semi-structured interviews with 14 COPD patients and nine HCPs to explore their perceptions of, and need for, PR in rural Maharashtra. Interviews were transcribed and analyzed thematically. Results: We approached 14 COPD patients and nine HCPs practicing in rural areas. Five HCPs stated that they did not advise PR for COPD patients citing poor compliance to PR referral and follow up of the patients. COPD patients had unmet needs but commented how transportation would be a problem for them to visit a PR Center. In contrast, they could understand the benefits of PR and expressed their willingness to join such programs. Since the study was being conducted during the COVID-19 Pandemic, a preference for home-based PR as a strategy was suggested by the HCPs to overcome concerns about visiting the centre due to the fear of infection. Conclusion: COPD patients have unmet needs that could benefit from attending a PR program, but there are barriers at both healthcare and patient levels that need to be addressed.