Enhancing Pulmonary Rehabilitation Access for Seniors with COPD through Knowledge Translation

Improving access to pulmonary rehabilitation (PR) for seniors with chronic obstructive pulmonary disease (COPD) means taking a closer look at their different barriers. These might include trouble getting around, not having the right technology, or gaps in the healthcare system that make it hard to get referred or stay engaged in programs. This is where Knowledge Translation (KT) and Integrated Knowledge Translation (iKT) come into play, helping to make sure research actually reaches and benefits the people who need it.

Knowledge Translation is a process that helps move research into real-world use. It includes creating easy-to-understand resources, educating healthcare providers, and developing evidence-based policies (Graham et al., 2006; CIHR, 2015). Integrated Knowledge Translation goes a step further by including the people who will use the research, such as patients, caregivers, and healthcare workers, right from the beginning. This makes the research more practical and relevant to everyday healthcare (Gagliardi et al., 2016). A good example of KT and iKT in action is the shift toward virtual and home-based PR programs, especially during and after the COVID-19 pandemic. These programs were designed to help seniors who couldn’t easily get to in-person sessions due to transportation, mobility, or health issues. When well-designed, these programs have shown results similar to traditional models, such as better breathing, improved fitness, and better overall well-being (Aburub et al., 2024; Mendes Xavier et al., 2022). In many cases, iKT strategies were used to design these programs. For example, older adults, caregivers, and healthcare professionals were invited to share their input during planning stages. Their feedback helped shape how the sessions were delivered. Some people preferred phone calls instead of video sessions, while others needed printed materials they could refer to at home. This kind of collaboration made the programs feel more accessible and comfortable for many seniors (Sami et al., 2021).

KT strategies also played an important role in getting these programs off the ground. These included developing plain-language brochures, offering tech help sessions, and training doctors and nurses on how to refer patients. In some places, clinics added automatic reminders in electronic health records to help ensure PR was discussed during regular checkups. Working with libraries, community centers, and home care programs also helped spread the word (Chopra et al., 2024; Grimshaw et al., 2012). When these efforts were evaluated, several strengths emerged. More people were able to access PR from home, the programs gave seniors more flexibility, and many participants appreciated the independence. Still, there were some drawbacks. Not everyone had internet access or a device, and some people weren’t comfortable with the technology. A few participants missed the in-person social interaction and found it harder to stay motivated on their own (Fien et al., 2022). To build on these programs, future KT efforts could offer more options. For instance, a mix of virtual, in-person, and telephone sessions could help meet different needs. Providing digital skills training ahead of time, assigning a support person like a community health worker, and offering materials in multiple languages could also help. On a larger scale, support from policy makers to improve internet access and fund equipment could make a big difference (CIHR, 2015; Gagliardi et al., 2016).

In short, using both KT and iKT together helps make sure that PR programs are not only evidence-based but also meaningful and usable for seniors. iKT brings real-life perspectives into the planning process, while KT helps share and support these solutions in healthcare settings. When combined, these approaches can lead to more inclusive programs and better health outcomes for older adults living with COPD.

References

Aburub, A., Darabseh, M., Badran, R., et al. (2024). The effects of digital health interventions for pulmonary rehabilitation in people with COPD: A systematic review of randomized controlled trials. Medicine, 60(6), 963. https://doi.org/10.3390/medicina60060963

Canadian Institutes of Health Research (CIHR). (2015). Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches. https://cihr- irsc.gc.ca/e/45321.html

Chopra, S., Rana, S., Patel, R., et al. (2024). Diversity in pulmonary rehabilitation clinical trials: A systematic review of the literature. Expert Review of Respiratory Medicine, 18(1–2), 49–58. https://doi.org/10.1080/17476348.2024.2324086

Fien, S., Dowsett, C., Hunter, C., et al. (2022). Feasibility, satisfaction, acceptability and safety of telehealth for First Nations and culturally and linguistically diverse people: A scoping review. Public Health, 207, 119–126. https://doi.org/10.1016/j.puhe.2022.04.007

Gagliardi, A. R., Berta, W., Kothari, A., Boyko, J., & Urquhart, R. (2016). Integrated knowledge translation (IKT) in health care: A scoping review. Implementation Science, 11(1), 38. https://doi.org/10.1186/s13012-016-0399-1

Graham, I. D., Logan, J., Harrison, M. B., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13–24. https://doi.org/10.1002/chp.47

Grimshaw, J. M., Eccles, M. P., Lavis, J. N., Hill, S. J., & Squires, J. E. (2012). Knowledge translation of research findings. Implementation Science, 7(1), 50. https://doi.org/10.1186/1748-5908-7-50

Mendes Xavier, D., Galvão, E. L., Fonseca, A. A., et al. (2022). Effects of home-based pulmonary rehabilitation on dyspnea, exercise capacity, quality of life and disease impact in COPD patients: A systematic review. COPD, 19(1), 18–46. https://doi.org/10.1080/15412555.2021.2020234

Sami, R., Salehi, K., Hashemi, M., & Atashi, V. (2021). Exploring the barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A qualitative study. BMC Health Services Research, 21(1), 828. https://doi.org/10.1186/s12913-021- 06814-5