The use of lay health workers in supporting patients with COPD to attend pulmonary rehabilitation: a qualitative study exploring the patient experience (ID 672)
King's College London
Abstract
Background and Aim
Pulmonary rehabilitation (PR) is the most effective treatment for the symptoms of chronic obstructive pulmonary disease (COPD), yet uptake and completion are low. The IMPROVE trial aimed to assess the effectiveness of recruiting and training patients who had completed PR to become lay health workers (i.e., PR-buddies), to support patients newly referred to PR. PR-buddies were trained to assess potential barriers to participation and help patients overcome them, emphasise the benefits of PR, and provide advice. The aim of this study was to explore the experiences of patients who received support from PR-buddies and the acceptability of PR-buddies from patients.
Methods
Patients who participated in the IMPROVE trial were invited to an interview to discuss their experiences. Interviews were semi-structured, audio-recorded, and transcribed verbatim for coding and inductive thematic analysis.
Results
Twenty patients from 11 IMPROVE trial sites across England participated. Three interviews were in-person, and the rest conducted by phone. Patients were happy with the support provided by their PR-buddy, which increased their confidence in attending PR. Patients liked the fact that PR-buddies had completed PR previously and so understood how they were feeling and could explain what to expect. Patients valued PR-buddies with good communication skills. The timing and mode of contact between PR-buddies and patients varied. Most patients preferred in-person contact initiated before the start of PR, and when subsequent contact was regular, predictable, and reliable. Patients largely accepted PR-buddies as strangers and appreciated their volunteer and lay-person status, as well as the fact they also had COPD, which made them more relatable. Additionally, patients enjoyed talking to and building relationships with their PR-buddies which alleviated low mood and isolation.
Conclusions
Patients thought the PR-buddy service was a good idea and found PR-buddy support acceptable. According to patients, the strength of PR-buddy support lies in their ability to relate to them and the use of their experience to provide confidence in attending PR.
Funding: The project is part of a process evaluation for the IMPROVE trial which was funded by NIHR.
Conflicts of interest: None.
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