Precision communication to optimise uptake of pulmonary rehabilitation in people with COPD

<bold>Aim:</bold> People with chronic obstructive pulmonary disease (COPD) can be reluctant to engage in a pulmonary rehabilitation program (PRP) when offered a referral. This study explored how the interaction between healthcare professionals (HCPs) and people with COPD can influence uptake of a PRP. <bold>Methods:</bold> We purposefully sampled Western Australians with COPD who expressed interest in sharing their experience of being recommended a PRP, and HCPs who refer to a PRP from tertiary care. Semi-structured interviews were recorded and transcribed verbatim. We conducted thematic analysis to deconstruct determinants influencing uptake of a referral to a PRP. <bold>Results:</bold> We conducted 56 interviews involving 17 people with COPD (p) and 37 HCPs (h) from March to July 2021. Themes generated include: (i) persona of the referrer <italic>“It's the attitude of the way they say it. It makes quite a bit of difference, whether they really believe it. I think that's important because then they pass that belief onto the patient.”(p12)</italic> (ii) unpacking unhelpful emotions/beliefs <italic>“Put hope into people and take away their fear. Sometimes we have perceptions, before we take up something, we think that's like that. But it's not. Sometimes if we clear that up, they think ‘oh actually, I can give it a go’.”(h1)</italic> <italic>“I judge myself. It's because I'm a smoker. And because of that, then you don't deserve treatment.”(p4)</italic> <bold>Conclusion:</bold> Interactions where HCPs demonstrate how invested they are in optimising outcomes meaningful to each patient are important when recommending people with COPD to a PRP. Precise conversations where fear of symptoms or exercise, and feelings of unworthiness are carefully acknowledged and challenged may facilitate greater PRP uptake.