ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Referral of patients with chronic obstructive pulmonary disease to pulmonary rehabilitation: a qualitative study of barriers and enablers for primary healthcare practitioners.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Supporting referral to pulmonary rehabilitation from primary care: A systematic evaluation of interventions using the ERIC taxonomy.NPJ primary care respiratory medicine · 2026Pooled it
- Global trends and research hotspots in pulmonary rehabilitation for chronic obstructive pulmonary disease: a bibliometric analysis (2000-2024).Journal of thoracic disease · 2026Article
- Tackling NHS winter pressures due to respiratory disease: the UK Centre for Applied Respiratory Research Innovation and Impact (CARRii).NPJ primary care respiratory medicine · 2026Review
- Exploring the perspectives of pulmonologists on referrals for pulmonary rehabilitation in India: insights into current practices.Scientific reports · 2026Article
- Internet of Things-Enabled Pulmonary Rehabilitation for Advanced Lung Cancer Patients Receiving Chemotherapy: A Qualitative Study of Healthcare Professional and Patient Perspectives.Journal of multidisciplinary healthcare · 2026Article
- Long-Term Monitoring of Individuals With Chronic Obstructive Pulmonary Disease Using Digital Health Technology: Qualitative Study.Journal of medical Internet research · 2025Article
- Efficacy of preoperative pulmonary rehabilitation in lung cancer patients: a systematic review and meta-analysis of randomized controlled trials.Discover oncology · 2025Article
- Recommendations for Improving Discharge-Related Care Following a COPD Exacerbation: An Expert Panel Consensus with Emphasis on Low- and Middle-Income Countries.International journal of chronic obstructive pulmonary disease · 2025Article
- Article
- Barriers and Enablers to Pulmonary Rehabilitation in Low- and Middle-Income Countries: A Qualitative Study of Healthcare Professionals.International journal of chronic obstructive pulmonary disease · 2022Article
- Treatable traits qualifying for nonpharmacological interventions in COPD patients upon first referral to a pulmonologist: the COPD sTRAITosphere.ERJ open research · 2020Article
- Barriers and challenges of implementing pulmonary rehabilitation in Malaysia: Stakeholders' perspectives.Journal of global healthArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary rehabilitation (PR) is a cost-effective, internationally recommended intervention for patients with chronic obstructive pulmonary disease (COPD). Referral is predominately led by primary healthcare practitioners (PHCPs), but referral and patient uptake is poor.
aimTo understand barriers and enablers for PHCPs when considering patient referral to PR, to explore the influence of patient characteristics, and to understand how referral rates may be increased. DESIGN AND
settingPHCPs who care for and refer patients with COPD to PR were purposively selected from general practices across Cambridgeshire and Peterborough, and the West Midlands.
methodA qualitative study. Semi-structured interviews were undertaken to theme saturation, exploring PR referral. Images depicting patients with varying COPD severity were used to stimulate memory and associative recall. Interviews were recorded, transcribed verbatim, and analysed using rapid qualitative analysis.
resultsA total of 19 PHCPs were interviewed. Barriers to PR referral included limited awareness of the clinical benefits, little knowledge of local PR providers, consultation time constraints, and presumed low patient motivation. While practice nurses had the greatest knowledge, they still described difficulty in promoting PR. PHCPs frequently described assessing patient suitability based on presumed accessibility, social, and disease-specific characteristics rather than the clinical benefits of PR. Referrals were facilitated by financial incentives for the practice and positive feedback from patients and providers.
conclusionThere were more barriers to PR referral than enablers. Providers must engage better with PHCPs, patients with COPD, and carers, and actively promote PR. Increasing PHCPs' awareness of the benefits of PR, financial incentives, and alternative referral pathways should be considered.
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