Exploring the perceptions of Patients with Chronic Respiratory Diseases and their insights into Pulmonary Rehabilitation in Bangladesh

Background: Chronic respiratory diseases (CRDs) require holistic management reflecting patient preferences, appropriate pharmacotherapy, pulmonary rehabilitation, and integrated care. We aimed to understand the perceptions of people with CRDs about their condition and pulmonary rehabilitation in Bangladesh.Methods: We conducted semi-structured interviews with a maximum variation sample of people with CRD who had participated in a feasibility study of pulmonary rehabilitation in 2021/ 2022. Interviews were transcribed verbatim, analysed in Bengali using a grounded theory approach and interpreted by a multidisciplinary team.Results: We interviewed 15 participants with COPD, asthma, or post-tuberculosis. Analysis revealed three themes. 1) Understanding CRD: patients characterised their condition by the symptoms (e.g., ‘Hapani’ meaning ‘breathlessness’) rather than describing a disease entity. Some identified occupation, previous infection or family history that they believed was the cause. 2) Perceptions of pulmonary rehabilitation: Exercise was counterintuitive as it exacerbated the breathlessness symptom that defined their disease. Views varied, though many acknowledged the benefits after a few sessions. Even with home-based programmes, participants described practical barriers to finding time for the sessions and adopted strategies to overcome the challenges. 3) Implementation: Participants highlighted the need for raising awareness of CRD and the potential of pulmonary rehabilitation in the community, adapting to the local context, and establishing an accessible resourced service. Conclusion: Understanding how patients and their communities perceive their condition and the barriers (both conceptual and logistical) to acceptance is the first step to embedding this highly effective intervention into routine healthcare services in Bangladesh with potential benefits for the increasing number of people living with CRDs in LMICs.<br/