Supporting referral to pulmonary rehabilitation for people with chronic respiratory disease: a two-phase co-design study

Referral of people with chronic respiratory disease to pulmonary rehabilitation (PR) remains low despite program benefits. We aimed to explore patient and health professional (HP) experiences of the PR referral process, to identify and co-design strategies to support referral. Focus groups and qualitative interviews were conducted in Phase 1, and a co-design workshop in Phase 2. Phase 1 included 14 people with lived experience and 10 HPs. Participants reported different experiences of the referral process highlighting patient expectation of only brief information about PR at the time of referral. Resources to promote PR awareness and knowledge, referral feedback, and HP education were developed in Phase 2 with inputs from two people with lived experience, three HPs and PR clinicians. In this study, participants identified new strategies to support referral to PR including the use of referral acknowledgement and focussed end rehabilitation feedback, and novel suggestions for HP education.