• David Harris, Mark Hayter, and Steven Allender.
• Killamarsh Medical Practice, Killamarsh, Sheffield. david.harris@nhs.net
• Br J Gen Pract. 2008 Oct 1; 58 (555): 703710703-10.

BackgroundPulmonary rehabilitation can improve the quality of life and ability to function of patients with chronic obstructive pulmonary disease (COPD). It may also reduce hospital admission and inpatient stay with exacerbations of COPD. Some patients who are eligible for pulmonary rehabilitation may not accept an offer of it, thereby missing an opportunity to improve their health status.AimTo identify a strategy for improving the uptake of pulmonary rehabilitation.Design Of StudyQualitative interviews with patients.SettingPatients with COPD were recruited from a suburban general practice in north-east Derbyshire, UK.MethodIn-depth interviews were conducted on a purposive sample of 16 patients with COPD to assess their concerns about accepting an offer of pulmonary rehabilitation. Interviews were analysed using grounded theory.ResultsFear of breathlessness and exercise, and the effect of pulmonary rehabilitation on coexisting medical problems were the most common concerns patients had about taking part in the rehabilitation. The possibility of reducing the sensation of breathlessness and regaining the ability to do things, such as play with their grandchildren, were motivators to participating.ConclusionA model is proposed where patients who feel a loss of control as their disease advances may find that pulmonary rehabilitation offers them the opportunity to regain control. Acknowledging patients' fears and framing pulmonary rehabilitation as a way of 'regaining control' may improve patient uptake.

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