Pulmonary rehabilitation for COPD: A narrative review and call for further implementation in Saudi Arabia

Aldhahir, Abdulelah M.; Alghamdi, Saeed M; Alqahtani, Jaber S; Alqahtani, Khaled A; Rajah, Ahmed M Al; Alkhathlan, Bedor; Singh, Sally; Mandal, Swapna; Hurst, John R.

doi:10.4103/atm.atm_639_20

Cited by 15 publications

(15 citation statements)

References 57 publications

(70 reference statements)

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“…One of the most frequently mentioned barriers to PR referral in this study was the availability of PR centers. In Saudi Arabia, a limited number of PR programs are available, which could serve only a limited number of patients with COPD [7]. This identifies a considerable gap in the practice and highlights the need to establish new programs that meet the international criteria across the country.…”

Section: Discussionmentioning

confidence: 99%

“…The finding that a home-based setting was perceived as the most suitable way to deliver a PR program may partially be explained by the limited number of PR centers in the country [7]. The COVID-19 pandemic, during which a curfew was imposed and most face-to-face PR services were forced to close temporarily, may have contributed to this.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the existing evidence supporting the use of PR among the COPD population, PR services are not widely utilized in Saudi Arabia [7][8][9]. In addition, the perceptions of healthcare professionals, particularly physicians, of delivering PR programs in Saudi Arabia have not been explored before.…”

Section: Introductionmentioning

confidence: 99%

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Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

et al. 2022

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This study aimed to assess physicians’ attitudes toward delivering pulmonary rehabilitation (PR) to chronic obstructive pulmonary disease (COPD) patients and identify factors and barriers that might influence referral decisions. Between September 2021 and January 2022, a cross-sectional online survey was distributed to all physicians in Saudi Arabia. A total of 502 physicians completed the online survey, of which 62.0% (n = 312) were male. General physicians accounted for 51.2%, while internal-medicine specialists and pulmonologists accounted for 26.9% and 6.6%, respectively. Only 146 (29%) physicians had referred COPD patients to a PR program. The difference in referral rates between all specialties (p = 0.011) was statistically significant. Physicians with more years of experience were more likely to refer COPD patients to PR (p < 0.001). Moreover, a home-based PR program was preferred by 379 physicians (75.5%), and 448 (89.2%) perceived smoking cessation as an essential component of PR. Availability of PR centers (69%) was the most common barrier for not referring patients to PR. The overall referral rate was low among all physicians, owing to a lack of PR centers and trained staff. Home-based delivery was the preferred method of delivering PR, with smoking cessation as an essential component.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

et al. 2022

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“…Further, non-smoking variables, such as biomass fuel, dusts, gases, and outdoor air pollution, are also commonly contributing to the increased burden of COPD in Saudi Arabia [ 18 ]. There are just a few pulmonary rehabilitation programs that are not extensively used in Saudi Arabia, owing to a lack of promotion and workforce competence [ 19 ]. Unavailability or underutilisation of such services would exacerbate the kingdom’s COPD burden.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, incidence, morbidity and mortality rates of COPD in Saudi Arabia: Trends in burden of COPD from 1990 to 2019

Alqahtani

2022

PLoS ONE

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Background The available data to determine the chronic obstructive pulmonary disease (COPD) burden in Saudi Arabia are scarce. Therefore, this study closely examines and tracks the trends of the COPD burden in Saudi Arabia from 1990 to 2019 using the dataset of the Global Burden of Disease (GBD) 2019. Methods This study used the GBD 2019 dataset to analyse the COPD prevalence, incidence, morbidity and mortality rates in the Saudi Arabian population from 1990 to 2019, stratified by sex and age. The age-standardised rate was used to determine the prevalence, incidence, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs) and deaths. Results In 2019, an estimated 434,560.64 people (95% Uncertainty Interval (UI) 396,011.72–473,596.71) had COPD in Saudi Arabia, corresponding to an increase of 329.82% compared with the number of diagnosed people in 1990 [101,104.05 (95% UI 91,334.4–111,223.91)]. The prevalence rate of COPD increased by 49%, from 1,381.26 (1,285.35–1,484.96) cases per 100,000 in 1990 to 2,053.04 (1918.06–2194.29) cases per 100,000 in 2019, and this trend was higher in males than females. The incidence rate of COPD in 2019 was 145.06 (136.62–154.76) new cases per 100,000, representing an increase of 43.4% from the 1990 incidence rate [101.18 (95.27–107.86)]. In 2019, the DALYs rate was 508.15 (95% UI 434.85–581.58) per 100,000 population. This was higher in males than females, with a 14.12% increase among males. In 2019, YLLs contributed to 63.6% of DALYs due to COPD. The death rate due to COPD was 19.6 (95% UI 15.94–23.39) deaths per 100 000 in 2019, indicating a decrease of 41.44% compared with the death rate in 1990 [33.55 deaths per 100 000 (95% UI 25.13–47.69)]. In 2019, COPD deaths accounted for 1.65% (1.39–1.88) of the total of deaths in Saudi Arabia and 57% of all deaths caused by chronic respiratory diseases. Conclusion Over the period 1990–2019, the prevalence and incidence of COPD in Saudi Arabia have been steadily rising. Even though COPD morbidity and death rates have been decreasing, they remain higher in men and older age. The holistic assessment and interventions with careful attention to optimising the community-based primary care management, such as screening for early diagnosis, smoking cessation programs and pulmonary rehabilitation, are likely to be the most successful strategies to reduce the burden of COPD in Saudi Arabia.

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“…[1][2][3] Over the next 30 years in the KSA, there will be a great need for RC services, due to population aging, increases in chronic respiratory disorders (particularly asthma and COPD), population growth in general, and developments and advancements in technology and treatment modalities. [8][9][10][11][12] In order to advance the science and practice of respiratory care in the KSA, establishing master's degree programs in the field are required. This will help to bridge the gap between academia, clinical research and practice, train future RC faculty, as well as to create a platform for multidisciplinary cooperation and study.…”

Section: Introductionmentioning

confidence: 99%

Needs Assessment for the Establishment of Master’s Degree Programs in Respiratory Care in the Kingdom of Saudi Arabia

Alqahtani¹,

AlAhmari²,

Al-Otaibi³

et al. 2022

AMEP

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Background Despite recent advancements in the respiratory care (RC) profession, no single institution in the Kingdom of Saudi Arabia (KSA) offers a master’s degree program in RC. Methods A nationwide and validated survey was used to explore the current needs and interests in establishing RC master’s degree programs in the KSA. The process included representatives from the healthcare industry, universities, and professional societies. Results A total of 1250 stakeholders across the KSA completed the survey. The sample includes 722 (58%) males, 504 (40%) respiratory therapists, 547 (44%) students, 138 (11%) leaders, and 61 (5%) were academic respondents. Most respondents were from Central 491 (39%) and Eastern 307 (25%) regions, with 1003 (80%) of the total sample worked or studied in governmental sectors. A total of 574 (82%) of the leaders and RTs had Bachelor degree and 430 (61%) of them had 1–5 years working experience. According to 80% of the employers and employees, only 0–5% of the RTs in their organization had a master’s degree. The calculated mean % of the agreement (agree/strongly agree) on the needs was 83% in all needs’ assessment items, which shows a great support for establishing a master’s in RC to meet the personal, professional and society needs. The mean % of the agreement for the level of interests among all participants was 86%, indicating a great level of interests in establishing a master degree in RC. The agreement % on the needs assessment and level of interests in establishing a master degree in RC in KSA were ≥80% in each stakeholder group. Conclusion There are obvious needs and interests in establishing master’s degree programs in RC in the KSA. A master’s degree in RC should be established to address the growing needs for advanced RC services throughout the nation and enhance RC research.

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Pulmonary rehabilitation for COPD: A narrative review and call for further implementation in Saudi Arabia

Cited by 15 publications

References 57 publications

Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

Physicians’ Attitudes, Beliefs and Barriers to a Pulmonary Rehabilitation for COPD Patients in Saudi Arabia: A Cross-Sectional Study

Prevalence, incidence, morbidity and mortality rates of COPD in Saudi Arabia: Trends in burden of COPD from 1990 to 2019

Needs Assessment for the Establishment of Master’s Degree Programs in Respiratory Care in the Kingdom of Saudi Arabia

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