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Agnes’* GP referred her to a programme to help her manage her breathing difficulties and get back to doing the things she loves. The programme was close to her home and wouldn’t cost her anything to attend. She receives all of the details over the phone as well as in the mail. But Agnes never turns up. Why?
That’s the question medical student, Dean Ramage is helping to answer as part of the University of Otago 2015-2016 Christchurch Summer Studentship Programme. Based at Pegasus Health, Dean has been working with the Canterbury Clinical Network’s Community Respiratory Service team to research the predictors of non-attendance to Pulmonary Rehabilitation.
Respiratory Nurse, Louise Weatherall said Canterbury’s community-based Pulmonary Rehabilitation Programme, like other pulmonary rehabilitation programmes around the world, has traditionally had a high rate of non-attendance.
“Canterbury’s Community Pulmonary Rehab Programme is helping hundreds of people with respiratory conditions every year through free education and exercise sessions provided in a safe and supportive environment.
“Programme graduates have reported feeling better equipped to manage their condition and it’s also helping reduce unnecessary visits to ED for people with respiratory conditions.
“But some people who are referred and accepted to the programme just never attend. We wanted to find out the reasons why and how we could support those non-attenders to get the same outcomes.”
With the help of Canterbury’s existing Pulmonary Rehabilitation Consumer Group, Dean was able to connect with 75 non-attenders to the programme on a personal level to find out their true reasons for not attending the programme.
Dean said his research suggests there are a number of common obstacles to attendance that can be addressed.
“Some of the main reasons I’ve uncovered include practical barriers like access to transport and conflicts with every day life like getting time off work. What was particularly interesting was the attitudes towards the programme and how this was influenced by the information given to patients.
“Many people believed they wouldn’t benefit from the programme and often thought that it wouldn’t be useful or relevant to them. It is clear that there are opportunities to improve the way information is given when people are first referred to address these beliefs and attitudes.
“Knowing these predictors to non-attendance means they can be addressed early.”
Dean’s recommendations will inform the ongoing quality improvement of the Pulmonary Rehabilitation Programme to encourage uptake of this beneficial activity for people with breathing difficulties.
Each year Pegasus Health takes on four students as part of the Summer Studentship programme, an initiative run by the University of Otago. Pegasus provides the funding, project supervisors and supports the students to complete projects that cover a range of topics including evaluating health services and programmes. CEO Vince Barry said, “The work conducted by the summer students is very valuable to us. It is a part of the year we look forward to and they always provide us with terrific insights into the work we do here.”
Dean was awarded the Best Over-All Project for this work in the Christchurch Summer Studentship Programme.
* Agnes is the Canterbury health system’s prototypical patient.
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