Barriers and challenges of implementing pulmonary rehabilitation in Malaysia: Stakeholders’ perspectives

• Published in: Journal of global health 2021-01, Vol.11, p.02003-02003, Article 02003
• Main Authors: Chan, Soo Chin, Sekhon, Jaspreet Kaur, Engkasan, Julia Patrick, Nathan, Jayakayatri Jeevajothi, Mirza, Fatim Tahirah, Liew, Su May, Hussein, Norita, Suhaimi, Anwar, Hanafi, Nik Sherina, Pang, Yong Kek, Yatim, Saari Mohamad, Jackson, Tracy, Fernandes, Genevie, Habib, G M Monsur, Pinnock, Hilary, Khoo, Ee Ming
• Format: Article
• Language: English
• Subjects: Chronic obstructive pulmonary disease; Collaboration; Community involvement; COVID-19; Decision making; Global health; Health care; Hospitals; Medical personnel; Medical referrals; Oxygen therapy; Patient admissions; Physical therapy; Quality of life; Rehabilitation; Stakeholders
• ISSN: 2047-2978; 2047-2986
• DOI: 10.7189/jogh.11.02003

CRDs cause a significant economic burden to both the patient and society as people living with CRD experience compromised quality of life and reduced work productivity, and frequent hospital admissions incur inpatient care costs [5]. Patients with CRDs are referred for physiotherapy by respiratory physicians and there are no standardised guidelines or referral pathways for these patients to receive PR. There is poor awareness among health care professionals about the service provision and referral mechanisms, inadequate rehabilitation services, long waiting lists for PR service, and a perception that patients do not want or need rehabilitation, creating barriers to effective implementation of a PR programme [10]. The National Institute of Health Research (NIHR) recommends undertaking stakeholder engagement to meet the needs and priorities of end users of research, however these activities are not commonplace in Malaysia, and this is one of the first Stakeholder Engagement activities for CRDs with regards to PR. BARRIERS AND CHALLENGES OF IMPLEMENTATION OF PULMONARY REHABILITATION (PR) PROGRAMME IN MALAYSIA In April 2021, we were joined by 110 health care professionals from public and private hospitals across every state in Malaysia. Table 1 A summary of the barriers and solutions to implementation of PR programmes in Malaysia Barriers to implementation of PR in Malaysia Proposed solution Low knowledge and awareness of PR among health care professionals Formal PR training of health care professionals; appointment of motivated programme coordinators with expert knowledge of PR Human resources, logistics and accessibility Installation of appropriate facilities and smooth communication pathways between departments in hospitals; utilising existing resources of health care professionals to carry out PR Lack of a structured PR programme Provide written guidelines, protocols and streamlined referral pathways Patient barriers to participation Community outreach programmes with hospital-community collaboration; patient education and awareness about PR; health care professionals working with patients to understand their needs and expectations regarding PR PR – pulmonary rehabilitation IMPLICATIONS FOR RESEARCH The key factors of limited awareness; poor multidisciplinary involvement; a lack of