Healthcare Providers’ Attitudes,Beliefs and Barriers to Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A National Survey

Abstract

Background:

Pulmonary rehabilitation (PR) is a core component of COPD patients’ management strategy. PR is administered by multidisciplinary healthcare providers (HCPs), but their attitudes toward delivering PR to COPD patients, factors and barriers that might influence referral have not been studied. This study aims to assess HCPs attitudes toward delivering PR to COPD patients and identify factors and barriers that might influence referral.

Methods:

A cross-sectional online survey consisting of 9 multiple-choice questions was distributed among HCPs in Saudi Arabia between September 2021 and January 2022. Descriptive statistics were used to describe the respondents’ characteristics. Categorical variables were reported as percentages and frequencies.

Results:

Overall, 980 HCPs, 520 of them male (53.1%), completed the online survey. Nurses accounted for 40.1% of the total sample size, while respiratory therapists and physiotherapists accounted for 32.1% and 16.5%, respectively. Most HCPs strongly agreed that PR would improve COPD patients’ exercise capacity 589 (60.1%), improve patients’ health-related quality of life 571 (58.3%), and improve disease self-management in COPD patients 589 (60.1%). Moreover, in-hospital supervised PR program was the preferred way to deliver PR for 748 (76.3%) HCPs, and 832 (84.9%) perceived information about COPD disease as an essential component of PR, followed by smoking cessation 787 (80.3%). The most common patient-related factor that strongly influenced referral decisions was mobility affected by breathlessness (64%), while availability of PR centers (61%), lack of trained HCPs (52%) and lack of authority to refer patients (44%) were the most common barriers for referring.

Conclusions:

PR is an effective management strategy for COPD patients, but sufficient PR centers, trained staff, and the authority to refer patients are lacking. An in-hospital supervised PR program is the preferred method of delivering PR, with information about COPD disease and smoking cessation being considered essential components of PR.

Patient-related factors that influence referral decision to PR, using strong, some or no influence grading.

Barriers to referring COPD patients to PR from HCPs perspective, using strong, some or no influence grading.