The optimal management of chronic respiratory disease presents a daunting challenge for Irish healthcare. The government’s “National Framework for the Integrated Prevention and Management in Chronic Disease in Ireland 2020-2025”, focusses on minimising admission to acute services through optimal and integrated community-based care. In particular, the ‘Physical Activity Pathway in Healthcare Model’ encourages the integration of physical activity into routine primary healthcare offerings. Pulmonary Rehabilitation (PR) is the gold standard for the non-pharmacological management of chronic respiratory disease. However, PR interventions are brief, under-resourced, and the long-term efficacy of offerings has not been established. Functional decline of participants in the following PR has been attributed to several factors including an absence of structures to support ongoing physical activity in the community.
A 2022 narrative review of the future of PR (McNamara et al, 2022) flagged the ethical and resource dilemmas of offering repeat PR programmes to patients who had already benefitted from PR. The authors then discussed community-based exercise maintenance programmes as a potential alternative to repeat PR programmes. The evidence around the composition, duration, frequency, referral criteria and oversight of such programmes is inconsistent, due largely to a lack of robust evidence in this area. In particular, there is a marked absence of the patient voice in the literature to inform the development of community-based exercise maintenance programmes for people with chronic respiratory disease.
This project will conduct focus groups with participants at three sites in the Mid-West (Limerick, Ennis and Nenagh) who have recently completed a course of PR. Their views on the composition and delivery of community-based exercise maintenance programmes will be gathered and analysed. This project will form part of a larger proposed research project exploring the feasibility and efficacy of such programmes to support optimal health for people with chronic respiratory disease.