Features of COPD That Lead to Stigmatisation and Its Consequences: A Framework Synthesis

COPD is a highly stigmatised condition. To develop effective measures to reduce COPD-related stigma, it is important to understand patients' experiences and identify contributing factors. This systematic review explores qualitative evidence regarding the features of COPD leading to stigmatisation and how it can potentially influence health outcomes. Electronic databases were searched to identify primary qualitative studies focussing on stigma-related experiences of adults with COPD, published between January 1988 to August 2024. Data were synthesised using framework synthesis. Twenty-nine studies with 427 participants were included in this review. Findings fit well into six themes identified from Jones et al.'s framework of stigma dimensions and provide rich description. Smoking habit was not the only factor of stigma but also factors that contributed to disability of individuals. Patients experience COPD-related stigma mainly from themselves and healthcare professionals. Potential consequences of stigma identified are mental distress, isolation, reduced help-seeking behaviour and non-compliance to management. Collective effort by society and healthcare systems will be necessary to alleviate the stigma associated with chronic symptoms and smoking behaviour of COPD and to promote the benefit of pulmonary rehabilitation and available mental health support.