The feasibility and acceptability of culturally appropriate pulmonary rehabilitation for Sri Lankan adults with COPD

<bold>Introduction:</bold> Pulmonary rehabilitation (PR) should be offered to individuals with COPD, but limited PR is practised in Sri Lanka. Catering for cultural diversity is crucial when designing and delivering PR. <bold>Aims:</bold> The study examined the feasibility and acceptability of a culturally adapted PR for adults with COPD in Sri Lanka. <bold>Methods:</bold> A randomized (1:1) controlled feasibility trial of culturally adapted PR enrolled 50 adults with COPD at Central Chest Clinic. Sri Lanka specific educational sessions, supervised group singing, and nutritional supplementation were incorporated. Feasibility was determined by uptake (initial assessment and first PR session) and completion (≥10/12 sessions/ discharge assessment). Acceptability was explored by qualitative interviews analysed thematically. <bold>Results:</bold> Doctors referred 84 adults (Sept 2022 to March 2023), 60 (71%) were screened for eligibility. PR trial uptake was 60%. Completion was 72% (n=18/25) in PR group and 64% (n=16/25) in control group (Fig 1). Based on generated themes, cultural adaptations were important, helping to demystify COPD, debunk nutrition myths, reduce fear for social engagement, increase medication adherence and build positive self-management behaviours. <bold>Conclusions:</bold> Culturally adapted PR appears feasible and acceptable to adults with COPD in Sri Lanka. A fully powered trial is recommended for evaluating clinical and cost-effectiveness of culturally adapted PR.