Identification des freins à la réhabilitation respiratoire chez le patient BPCO. Étude qualitative par focus group et entretiens individuels auprès des patients, des médecins généralistes, des médecins du sport, des pneumologues et des professionnels de santé paramédicaux

Abstract

Although pulmonary rehabilitation is a core treatment for chronic obstructive pulmonary disease (COPD) approved by the French National Authority for Health, there is no doubt that it is insufficiently used in France. Pulmonary rehabilitation consists of exercise training and patient education delivered in a multidisciplinary programme of care to reverse the downward spiral of deconditioning caused by the illness as well as improving patients' ability to self-manage. The aim of this study was to identify the obstacles that prevent the delivery of pulmonary rehabilitation, so as to understand its lack of use. A qualitative study was undertaken with semi-structured interviews in focus groups and individually, involving the different actors within COPD care pathways, including doctors, other healthcare professionals, and patients. Three group interviews and nine individual interviews were analysed. From these, 13 issues appeared: the disease itself, the perception of the disease, the multidisciplinary work, the relationship between caregivers and the patient, motivation, smoking, the comorbidities, fear, geography, economy, the social, the temporality and the establishment of a pulmonary rehabilitation programme. This work illustrates the many barriers that will be interesting to explore, in order to increase the use of pulmonary rehabilitation for patients with COPD.