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Background: Chronic obstructive pulmonary disease (COPD) and asthma rank among the leading causes of respiratory morbidity, particularly in low- and middle-income countries. This qualitative study aimed to explore the healthcare pathways of patients with chronic respiratory disease, and factors influencing their ability to access healthcare in Vietnam, where COPD and asthma are prevalent., Methods: We conducted 41 in-depth interviews among patients, including 31 people with COPD, eight with asthma and two with asthma-COPD overlap syndrome. Participants were recruited at provincial- or national-level health facilities in two urban and two rural provinces in Vietnam. The interviews were audio-recorded, transcribed, and analysed using thematic analysis., Results: Patients' healthcare pathways were complex and involved visits to multiple health facilities before finally obtaining a definitive diagnosis at a provincial- or national-level hospital. Access to healthcare was affected considerably by participants' limited knowledge of their respiratory conditions, the availability of social support, especially from family members, the costs of healthcare as well as health system factors (including the coverage of public health insurance, the distance to health facilities, and attitude of healthcare providers)., Conclusion: The study demonstrated the need for improved access to timely diagnosis and treatment of chronic lung disease within the lower level of the health system. This can be achieved by enhancing the communication skills and diagnostic capacity of local healthcare workers. Health education programmes for patients and caregivers will contribute to improved control of lung disease.

Here, we describe the clinical course of a patient with chronic obstructive pulmonary disease treated with autologous adipose-derived stem cell therapy. In September 2019, our patient was admitted to Bach Mai Hospital. His post-bronchodilator forced expiratory volume in 1 sec (FEV 1 ) was 21% and FEV 1 /forced vital capacity (FVC) was 40%. He had suffered from two exacerbations of chronic obstructive pulmonary disease (COPD) in the previous year. He received treatment with autologous stem cells from adipose tissue. Follow-up indicated that autologous stem cells from adipose tissue was a safe treatment and improved the patient's dyspnoea and quality of life., (© 2021 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.)