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Healthcare Professionals’ Perspectives on Adherence Management in Home-Based Pulmonary Rehabilitation: A Qualitative Study

Year: 2026

Type: article

Abstract: Background: Home-based pulmonary rehabilitation (PR) is increasingly promoted to expand access and continuity of COPD care. However, adherence to home-based PR remains a persistent challenge. Existing research has mainly focused on patient-related determinants, with limited understanding of healthcare professionals' experiences shaping adherence management. Methods: A qualitative descriptive design was adopted. Semi-structured interviews were conducted with 18 healthcare professionals, including respiratory physicians, nurses and rehabilitation therapists, who were involved in home-based PR. Participants were purposively sampled from a regional PR training program in China. Recruitment continued until data saturation was reached. Data were analyzed using thematic analysis. Results: Three themes were identified: current practice of home-based PR, barriers to adherence management, and facilitators of adherence management. Healthcare professionals described current implementation as inconsistent, with variable assessment practices and limited follow-up. Barriers to adherence management included insufficient time and energy, weak multidisciplinary collaboration, limited use of remote rehabilitation technologies, and safety concerns during home visits. Facilitators included professional knowledge, trusting relationships with patients, strong professional commitment, performance-based incentives, and multisectoral collaboration across stakeholders. Conclusion: This study reveals the complexity of adherence management in home-based PR and emphasizes the crucial role of healthcare professionals in supporting patients' sustained participation. The identified barriers and facilitators may inform future strategies to improve adherence management in routine practice.

Source: International Journal of COPD

DOI: 10.2147/copd.s643843