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A7068 - ‘Let’s Start the Conversation⋯’ - The Perspectives of Health Care Professionals on Physical Activity Prescription for People with COPD
Author Block: A. Lahham1, C. McDonald2, A. Burge3, A. E. Holland3; 1Discipline of Physiotherapy, La Trobe University / Institute for Breathing and Sleep, Melbourne, Australia, 2Department of Respiratory and Sleep Medicine, Austin Health / University of Melbourne / Institute for Breathing and Sleep, Melbourne, Australia, 3Discipline of Physiotherapy, La Trobe University / Alfred Health / Institute for Breathing and Sleep, Melbourne, Australia.
Introduction: Clinical practice guidelines recommend that people with chronic obstructive pulmonary disease (COPD) should be encouraged to be more physically active. However, it is not clear how guidelines are applied in practice. Reporting the perspectives of respiratory health care professionals (HCP) regarding physical activity (PA) advice and prescription would assist translation of PA recommendations into clinical practice. Methods: An interview-based qualitative study including 30 respiratory HCP was conducted. Interviewed HCP (12 physicians, 10 physical therapists, four nurses and four exercise physiologists) all provide care for patients with COPD. Semi-structured interviews were conducted, transcribed verbatim and analysed by two independent researchers using thematic analysis. Results: Six overarching themes emerged from synthesis of the interviews. (1) Respiratory HCP acknowledged the importance of PA for people with COPD and identified it as a key component of management. (2) HCP were conscious of low PA levels; however, few specifically address this issue in practice. (3) Physicians described limitations including time constraints, pharmacological treatment prioritisation and perceived lack of expertise; as a result they preferred to refer to physical therapist for more comprehensive assessment and advice regarding PA. (4) Most HCP viewed pulmonary rehabilitation as an essential intervention to enhance COPD outcomes, but PA was poorly differentiated from exercise training. (5) Although HCP were aware of guidelines regarding prescription of PA, few were able to recall specific recommendations for people with COPD. (6) HCP perceived that there were few evidence based strategies to enhance PA. Conclusion: Respiratory HCP perceive that enhancing PA is a key element of COPD care, however this is not always addressed in practice. A structured approach to assessment and prescription of PA could assist HCP to discuss PA during clinical consultations. Grant Support: None to declare