Health inequalities: understanding barriers in attending pulmonary rehabilitation

<bold>Introduction:</bold> There are wide disparities in respiratory health in the UK. This is exacerbated by health inequalities across the population (NHS, 2019). Such inequalities can have an impact on engaging in pulmonary rehabilitation (PR) (Gardiner and Singh, 2022). There is a need to understand and act upon such inequalities to ensure fair access to PR and improve the quality of life for those living with chronic respiratory disease. <bold>Aim:</bold> To understand potential health inequalities impacting on PR attendance. <bold>Methods:</bold> Patients were identified using a PR service database and included if they had declined or did not attend a PR assessment between July 2022 and June 2023. The characteristics of these patients were: firstly, analysed by referral source, gender, ethnicity, diagnosis and location. Secondly, patients were invited to a focus group to discuss the barriers to attending PR. The focus group was facilitated by PR staff and notes taken to record discussion. <bold>Results:</bold> 192 patients were included; results include links between PR non-attendance with referral source and geographical location. 5 patients attended a focus group (see table 1). Overall themes included; awareness of referral, location and accessibility and knowledge of PR. Table 1 <table-wrap><object-id>erj;64/suppl_68/PA3171/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col></colgroup><tbody><tr><td>Age</td><td>67. 6 (average years)</td></tr><tr><td>Gender</td><td>Male (60%) Female (40%)</td></tr><tr><td>Ethnicity</td><td>White-British (100%)</td></tr><tr><td>Marital-Status</td><td>Married (60%) Single (40%)</td></tr><tr><td>Diagnosis</td><td>COPD (60%) Bronchiectasis (20%) Multifactorial breathlessness (20%)</td></tr><tr><td>DNA/Declined</td><td>Did not attend (60%) Declined (40%)</td></tr></tbody></table></table-wrap> <bold>Discussion:</bold> This study has contributed to understanding the potential health inequalities behind patients not attending PR. This informs how best to maximise access and uptake to ensure target groups benefit from PR.